Document of The World Bank FOR OFFICIAL USE ONLY Report No: ICR00005426 IMPLEMENTATION COMPLETION AND RESULTS REPORT <4789-GH and 6128-GH> ON A CREDIT IN THE AMOUNT OF SDR 82.7 MILLION (US$ 120.7 MILLION EQUIVALENT) TO THE REPUBLIC OF GHANA FOR A SUSTAINABLE RURAL WATER & SANITATION PROJECT March 23, 2021 Water Global Practice Africa West Region CURRENCY EQUIVALENTS (Exchange Rate Effective June 30, 2020) Currency Unit = GHS GHC 5.64= US$1 US$ 1.37 = SDR 1 FISCAL YEAR January 1 – December 31 Regional Vice President: Ousmane Diagana Country Director: Pierre Frank Laporte Regional Director: Simeon Kacou Ehui Practice Manager: Yogita Mumssen Task Team Leader(s): Yitbarek Tessema Mammo ICR Main Contributor: Alexandru Cosmin Buteica ABBREVIATIONS AND ACRONYMS AF Additional Financing AM Aide Memoire ARAPs Abbreviated Resettlement Action Plans BCC Behavioral change communication CAS Country Assistance Strategy CBA Cost–benefit analysis CLTS Community Led Total Sanitation CPS Country Partnership Strategy CWSA Community Water and Sanitation Agency DAs District Assemblies DEHOs District Environmental Health Officers DiMES District Monitoring and Evaluation System DWSTs District Water and Sanitation Team ESMF Environmental and Social Management Framework ESMP Environmental and Social Management Plan FM Financial Management FY Fiscal Year GoG Government of Ghana GPRS Ghana Poverty Reduction Strategy GRM Grievance Redress Mechanism GWCL Ghana Water Company Ltd HDPE High-density polyethylene IDA International Development Association IRR Internal Rate of Return M&E Monitoring and Evaluation MDG Millennium Development Goals MSWR Ministry of Water Resources Works MTR Mid-term review NCWSP National Community Water and Sanitation Program NPV Net Present Value O&M Operations & Maintenance ODF Open Defecation Free PAP Project Affected Person PDO Project Development Objective PVC Polyvinyl chloride RCC Regional Coordinating Councils RPF Resettlement Policy Framework RWST Regional Water and Sanitation Team SCD Systematic Country Diagnostic SDG Sustainable Development Goals SIP Strategic Investment Plan SRWSP Sustainable Rural Water and Sanitation Project SIS Sector Information System US$ United States Dollar WASH Water, sanitation and hygiene WB World Bank WSMT Water and Sanitation Management Teams WSS Water Supply and Sanitation TABLE OF CONTENTS DATA SHEET .......................................................................................................................... 1 I. PROJECT CONTEXT AND DEVELOPMENT OBJECTIVES ....................................................... 5 A. CONTEXT AT APPRAISAL .........................................................................................................5 B. SIGNIFICANT CHANGES DURING IMPLEMENTATION (IF APPLICABLE) .....................................10 II. OUTCOME .................................................................................................................... 12 A. RELEVANCE OF PDOs ............................................................................................................12 B. ACHIEVEMENT OF PDOs (EFFICACY) ......................................................................................13 C. EFFICIENCY ...........................................................................................................................16 D. JUSTIFICATION OF OVERALL OUTCOME RATING ....................................................................18 E. OTHER OUTCOMES AND IMPACTS (IF ANY)............................................................................18 III. KEY FACTORS THAT AFFECTED IMPLEMENTATION AND OUTCOME ................................ 20 A. KEY FACTORS DURING PREPARATION ...................................................................................20 B. KEY FACTORS DURING IMPLEMENTATION .............................................................................21 IV. BANK PERFORMANCE, COMPLIANCE ISSUES, AND RISK TO DEVELOPMENT OUTCOME .. 23 A. QUALITY OF MONITORING AND EVALUATION (M&E) ............................................................23 B. ENVIRONMENTAL, SOCIAL, AND FIDUCIARY COMPLIANCE .....................................................25 C. BANK PERFORMANCE ...........................................................................................................26 D. RISK TO DEVELOPMENT OUTCOME .......................................................................................28 V. LESSONS AND RECOMMENDATIONS ............................................................................. 28 ANNEX 1. RESULTS FRAMEWORK AND KEY OUTPUTS ........................................................... 31 ANNEX 2. BANK LENDING AND IMPLEMENTATION SUPPORT/SUPERVISION ......................... 43 ANNEX 3. PROJECT COST BY COMPONENT ........................................................................... 45 ANNEX 4. EFFICIENCY ANALYSIS ........................................................................................... 46 ANNEX 5. BORROWER, CO-FINANCIER AND OTHER PARTNER/STAKEHOLDER COMMENTS ... 51 ANNEX 6. SUPPORTING DOCUMENTS (IF ANY) ..................................................................... 52 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) DATA SHEET BASIC INFORMATION Product Information Project ID Project Name P120026 GH:Sustainable Rural Water & Sanit Serv Country Financing Instrument Ghana Investment Project Financing Original EA Category Revised EA Category Partial Assessment (B) Partial Assessment (B) Organizations Borrower Implementing Agency CWSA, Community Water and Sanitation Agency (CWSA), Ministry of Finance, Ministry of Finance Community Water & Sanitation Agency Project Development Objective (PDO) Original PDO The objective of the Project is to expand access to, and ensure sustainable water supply and sanitation services in rural and small town communities in six regions of Ghana. Page 1 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) FINANCING Original Amount (US$) Revised Amount (US$) Actual Disbursed (US$) World Bank Financing 75,000,000 74,996,829 74,462,331 IDA-47890 45,700,000 45,693,985 46,065,170 IDA-61280 Total 120,700,000 120,690,814 120,527,501 Non-World Bank Financing 0 0 0 Borrower/Recipient 2,340,000 0 0 Total 2,340,000 0 0 Total Project Cost 123,040,000 120,690,814 120,527,501 KEY DATES Approval Effectiveness MTR Review Original Closing Actual Closing 23-Jun-2010 06-Dec-2010 04-Jun-2014 30-Jun-2016 30-Jun-2020 RESTRUCTURING AND/OR ADDITIONAL FINANCING Date(s) Amount Disbursed (US$M) Key Revisions 29-Jun-2016 74.46 Change in Loan Closing Date(s) 28-Jun-2017 74.46 Change in Loan Closing Date(s) 23-Dec-2019 112.41 Change in Results Framework Change in Loan Closing Date(s) Change in Implementation Schedule KEY RATINGS Outcome Bank Performance M&E Quality Satisfactory Moderately Satisfactory Substantial Page 2 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) RATINGS OF PROJECT PERFORMANCE IN ISRs Actual No. Date ISR Archived DO Rating IP Rating Disbursements (US$M) 01 26-Mar-2011 Satisfactory Satisfactory 0 02 27-Nov-2011 Satisfactory Satisfactory 2.50 03 11-Jun-2012 Satisfactory Satisfactory 7.19 04 21-Jan-2013 Satisfactory Moderately Satisfactory 11.18 05 18-Sep-2013 Satisfactory Moderately Satisfactory 21.39 06 01-Apr-2014 Moderately Satisfactory Moderately Satisfactory 44.99 07 13-Oct-2014 Satisfactory Moderately Satisfactory 53.05 08 27-Apr-2015 Satisfactory Satisfactory 67.46 09 14-Dec-2015 Moderately Satisfactory Moderately Satisfactory 73.66 10 30-Jun-2016 Moderately Satisfactory Moderately Satisfactory 74.46 11 16-Dec-2016 Moderately Satisfactory Moderately Satisfactory 74.46 12 27-Jun-2017 Moderately Satisfactory Moderately Satisfactory 74.46 13 29-Dec-2017 Moderately Satisfactory Moderately Satisfactory 74.46 14 11-Jun-2018 Moderately Satisfactory Moderately Satisfactory 81.42 15 21-Dec-2018 Moderately Satisfactory Moderately Unsatisfactory 81.42 16 15-Mar-2019 Moderately Satisfactory Moderately Satisfactory 105.27 17 28-Jun-2019 Moderately Satisfactory Moderately Satisfactory 105.27 18 16-Dec-2019 Moderately Satisfactory Moderately Satisfactory 112.41 19 04-Apr-2020 Satisfactory Satisfactory 116.73 Page 3 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) SECTORS AND THEMES Sectors Major Sector/Sector (%) Water, Sanitation and Waste Management 100 Sanitation 25 Water Supply 60 Public Administration - Water, Sanitation and Waste 15 Management Themes Major Theme/ Theme (Level 2)/ Theme (Level 3) (%) Private Sector Development 10 Public Private Partnerships 10 Urban and Rural Development 100 Rural Development 100 Rural Infrastructure and service delivery 100 ADM STAFF Role At Approval At ICR Regional Vice President: Obiageli Katryn Ezekwesili Ousmane Diagana Country Director: Ishac Diwan Pierre Frank Laporte Director: Inger Andersen Simeon Kacou Ehui Practice Manager: Jaime M. Biderman Yogita Mumssen Task Team Leader(s): Ventura Bengoechea Yitbarek Tessema Mammo ICR Contributing Author: Alexandru Cosmin Buteica Page 4 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) I. PROJECT CONTEXT AND DEVELOPMENT OBJECTIVES A. CONTEXT AT APPRAISAL Context 1. Ghana experienced an increase in access to improved water supply in small towns and rural communities from 1990 to the end of 2009, rising from as low as 27 percent to approximately 60 percent. At the time, more than 12 million people were estimated to live in rural areas. Despite the significant increase in access to water supply, in large ensured by Ghana’s National Community Water and Sanitation Program (NCWSP) launched in 1994, Ghana still needed to continue its efforts to remain on track to achieve the Millennium Development Goals (MDG) target for 2015 of 76 percent of the population with access to improved water supply. At the same time, the MDG goal for access to sanitation was considerably off track, with only 12 percent estimated coverage, compared to the MDG target of 53 percent 1, and only 7 percent having access to sanitation in rural areas. 2. Investments in safe drinking water, improved sanitation and good hygiene practices in rural areas were considered pre-requisites to good health, increased productivity, and subsequently wealth creation and poverty reduction. As such, increasing access to safe drinking water and sanitation represented priorities for the Government of Ghana (GoG), as encompassed in the National Water Policy (2007) and the principles enunciated in the Ghana Poverty Reduction Strategy (GPRS 2000-2005 and GPRS-II 2006-2009), the National Medium-Term Development Policy Framework (2010-2013), the Millennium Development Goals, and the “Africa Water Vision” of the New Partnership for Africa’s Development. The institutional framework of the water and sanitation sector had also been strengthened 2 over the past years by the Government of Ghana. 3. The World Bank Group had been actively committed to contributing to the development of the rural water supply and sanitation sector in Ghana, as reflected in the Country Assistance Strategy (CAS) for FY04-07, which included ample support to the reforms and increases in coverage in Ghana’s water sector by means of Phases 1 and 2 of the Second Community Water and Sanitation Project (P047264 & P099552) and the Community Based Rural Development Project (P081482). As mentioned in the PAD, Despite the significant progress recorded for access to water, the sustainability of facilities and services was highlighted as an issue across Ghana, especially regarding the renewal and replacement of assets when they reached the end of their useful life, while access to sanitation was very low. Provision of rural water and sanitation services remained a top priority reflected under the CAS for FY08-11. 1 WHO/UNICEF JMP, 2010 2 Efforts included: issuance of the National Water Policy (NWP) in 2007; establishment of a Water Directorate (WD) within the civil service structure of the Ministry of Water Resources Works and Housing (MWRWH) in 2008 to assist with policy formulation and sectoral coordination; establishment of the Environmental, Health and Sanitation Directorate (EHSD) under the Ministry of Local Governments and Rural Development (MLGRD) in 2009. Several other instruments had ensured operational transparency among stakeholders in the sector, such as: the development of Strategic Investment Plans for Rural Water and Urban Water, the National Community Water and Sanitation Strategy, the Public Procurement Act, the Internal Audit Agency Act. The creation of the Water Directorate, the Environmental, Health, and Sanitation Directorate, the Multi-Donor Budgetary Support (MDBS) Mechanism, the GoG-Development Partner (GoG-DP) Water and Sanitation Sector Group, and the GoG-DP Joint Sector Annual Review Conferences had also helped to build cooperation, coordination and harmonization between government and non- governmental organizations, stakeholders and Development Partners (DPs). Page 5 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) 4. A new operation, the Sustainable Rural Water and Sanitation Project – SRWSP, was initiated to support the continued implementation of the NCWSP and provide access to safe water, sanitation and hygiene services to rural communities and small towns in six regions of Ghana. The project would contribute towards covering the financial sector gap of US$330 million identified by the Community Water and Sanitation Agency (CWSA) in its 2008-2015 Strategic Investment Plan (SIP). The operation would aim to improve sustainability of water services by supporting decentralization of responsibilities to and strengthening of the District Assemblies (DAs) and the Regional Coordinating Councils (RCCs). The project was also envisioned to support the promotion of Community Led Total Sanitation (CLTS) to create awareness and generate demand for sanitation, with the goal of helping communities to achieve an Open Defecation Free (ODF) status and move the people higher on the sanitation ladder. 5. The SRWSP, through an IDA credit in the amount of SDR 49.70 million, equivalent to US$75 million, was approved by the Bank’s Board on June 23, 2010, signed on September 8, 2010, and was declared effective on December 6, 2010, with an original closing date of June 30, 2016. Theory of Change (Results Chain) 6. The project included three components: Component A – rural and small town water supply; Component B – rural and small town integrated sanitation and hygiene promotion; and Component C – institutional strengthening and project management. At the time of project appraisal, it was not required to prepare a Theory of Change. The Theory of Change represented below has been inferred from the Project Appraisal Document. 7. Activities: As shown in Figure 1, the underlying logic of the proposed activities was to expand access to drinking water and improve sanitation in small towns and rural areas in six regions of Ghana (Central, Western, Brong- Ahafo, Northern, Upper East, and Upper West), strengthening the DAs and sector institutions to improve subproject implementation and ensure long-term sustainability of water supply and sanitation services. The main activities under Components A and B of the project included: provision of boreholes fitted with hand pumps for rural communities; provision of medium-sized systems based on mechanized boreholes for medium-sized small towns; provision of large-sized systems based on mechanized borehole for larger sized small towns; connection to transmission lines from Ghana Water Company Ltd 3 (GWCL) systems for communities or small towns (e.g. coastal communities with saline groundwater located near urban systems); rehabilitation of good- yielding, broken-down “orphan” 4 boreholes in rural communities and small towns; rehabilitation of non-optimal performing water supply systems in small towns transferred from the GWCL; construction of core elements of basic household latrines; construction of institutional latrines for schools and health facilities located within the project area; and, behavioral change education and communication campaigns for improved sanitation and hygiene. Activities under the project management and institutional strengthening Component C included: technical assistance, establishment of a Sector Information System for information sharing, coordination and monitoring and evaluation in water and sanitation development and operations; and, operational support and training. 8. Outputs: Several outputs were expected, such as: increased number of new operational water systems based on boreholes fitted with hand pumps; increased number of new operational medium-sized piped systems; increased number of constructed or rehabilitated community water points; improved number of rehabilitated orphan boreholes; increased number of constructed household toilet facilities with handwashing facilities, as well as constructed and operational institutional toilet facilities; increased number of communities trained for 3National utility responsible for the provision of water to people in urban areas. 4 Common name given in Ghana to old boreholes, usually over 30 years old, which are not claimed by any donor and are normally equipped with old non-standard hand pumps for which parts are no longer available. Page 6 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) hygiene behavioral change or sanitation practices; establishment of a robust Sector Information System to facilitate information sharing, coordination, and to enhance M&E roles among the water and sanitation actors; and, strengthened capacities of key stakeholders in the water and sanitation sector for effective subproject implementation, operation, monitoring and supervision. 9. Outcomes: The project outputs were intended to contribute to the project outcomes focused on increasing and ensuring access to sustainable water supply and sanitation services in rural and small town communities in six regions of Ghana. 10. Long-term outcomes: In the long term, the project would provide improved health and hygiene practices, contributing to human development, leading to increased economic benefits in the targeted areas, and would contribute to strengthening local capacity, governance and decentralization to more sustainably manage rural and small town water and sanitation facilities. 11. Institutional capacity building: The project design aimed to establish stronger institutions, enhancing the capacity of the implementing agencies (through technical assistance, trainings logistical support etc.) to sustainably manage, operate and monitor water supply and sanitation schemes in rural communities and small towns and thus enhance the sustainability of the water supply and sanitation services provided, as part of a broader longer-term framework that would enhance sector sustainability going forward. The institutional arrangements for the implementation of subprojects fell within the framework of the decentralization program of the Government of Ghana (GOG). The DAs would play the leading role in subproject implementation, while the CWSA would coordinate the overall program and provide technical support and advice to the local government institutions for project implementation and management and serve as liaison with the World Bank. The Regional Coordinating Councils (RCCs) were responsible for contracting consultants whose services included the study and design of water supply services, the design of institutional toilets and the promotion of sanitation programs, including the CLTS, which cut across DAs. The DAs were responsible for contracting out subproject works for water supply and institutional toilets which were normally packaged in district lots. Page 7 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Page 8 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Project Development Objectives (PDOs) 12. The objective of the Project is to expand access to, and ensure sustainable water supply and sanitation services in rural and small town communities in six regions of Ghana. Key Expected Outcomes and Outcome Indicators 13. The Project was expected to have three main outcomes: 1) expand access to water supply services; 2) expand access to sanitation services; and 3) ensure sustainable water supply and sanitation services. The target areas were the rural and small-town communities in six regions of Ghana: Central, Western, Brong-Ahafo, Northern, Upper East, and Upper West. The project was expected to provide improved access to sanitation and water supply to at least 600,000 people living in these six regions. 14. The key PDO outcome indicators included the following: Table 1. Outcomes and Indicators (as at Appraisal Stage) Outcome PDO Indicators Expand access to sustainable • Number of people in project area with access to improved water supply water supply services • Number of direct project beneficiaries 5, of which (percent) are females Expand access to sustainable • Number of people in project area with access to improved sanitation sanitation services • Number of communities in project area declared free of open defecation Ensure sustainable water • Reliability of water supply services in project area [average hours of supply and sanitation services service per day] • Water systems in project areas with ratio of revenues over operation and maintenance costs (including depreciation) equal or greater than 1 Components 15. Component A – Rural and Small Town Water Supply (cost at appraisal US$ 47.6 million; increased to US$ 77.6 million after additional financing; actual cost at completion US$ 85.22 million). This component aimed at contributing to the first objective of the PDO and supported the increase and improvement of access to water supply through the construction and rehabilitation of point sources and piped water supply systems. Depending on the size of the communities’ population, this component included several solutions: boreholes fitted with hand pump for rural areas; medium-sized systems based on mechanized boreholes for medium-sized small towns; large-sized systems based on mechanized borehole for larger sized small towns. Other activities included: connection to transmission lines from GWCL systems for communities or small towns; rehabilitation of good yielding, broken down “orphan” boreholes in rural communities and small towns; and rehabilitation of non- optimal performing water supply systems in small towns transferred from the GWCL. 16. Component B – Rural and Small Town Integrated Sanitation & Hygiene Promotion (cost at appraisal US$ 18.6 million; increased to US$ 29.8 million after additional financing; actual cost at completion US$ 21.04 million). This component aimed at contributing to the second objective of the PDO and was aimed at accelerating the pace for attainment of MDG for sanitation by targeting whole communities and small towns within the project 5 Direct project beneficiaries were considered those that would get access to improved water supply, improved sanitation or both (no double counting). The higher number (those with access to improved water supply) was chosen for this assessment. Page 9 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) area to reach open-defecation free status. This component financed core elements of a basic household latrine, such as the slab, as well as the construction of institutional latrines for schools and health facilities located within the project area. Other financed activities under this component supported the development of behavioral change communication strategies, including the use of inter-personal communication and mass media, to bring about change in hygiene behavior and sanitation awareness and attitude among stakeholders. 17. Component C – Institutional Strengthening and Project Management (cost at appraisal US$ 11.1 million; increased to US$ 15.6 million after additional financing; actual cost at completion US$ 14.27 million). This component was designed to support capacity building and technical assistance, as well as logistics, to streamline roles and strengthen capacities of key stakeholders in the water and sanitation sector for effective sub-project implementation, operation, monitoring and supervision. B. SIGNIFICANT CHANGES DURING IMPLEMENTATION (IF APPLICABLE) Revised PDOs and Outcome Targets 18. The original PDO was not modified during project implementation. Restructurings of the project (in June 2016 and June 2017) extended the project closing date to maintain the achievement of the PDO. An Additional Financing (AF) of US$ 47.5 million was approved June 2017 and signed in November 2017 extending the closing date to December 31, 2019. A final restructuring in December 2019 extended the project closing date to June 30, 2020. Revised PDO Indicators 19. A few changes to result indicators were recorded in the Results Framework (at the Additional Financing stage) to reflect the revised project closing date; the target values of some indicators were revised upwards to reflect the greater number of people that would be covered by the investments in the selected communities. The revised target values are highlighted in Table 2. No indicators were added, nor dropped during the project implementation. Table 2. Revised targets for PDO Indicators and Intermediate Results Indicators Baseline/First Revised targets for PDO Indicators and Original Targets Revised Unit Measure Year Intermediate Results Indicators as in the PAD Target Measurement PDO INDICATORS [REVISED target] Direct project beneficiaries Number 0 600,000 800,000 [REVISED target] Number of people in rural Number 0 600,000 800,000 areas provided with access to Improved Water Sources under the project INTERMEDIATE RESULTS INDICATORS [REVISED target] New Institutional toilet Number 0 200 400 facilities constructed and operational [REVISED target] New mechanized Number 0 40 60 boreholes operational [REVISED target] New water systems for Number 0 30 60 small towns operational Page 10 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Revised Components 20. The overall structure and objectives of the project components were not changed during the restructurings. The additional financing covered the following: • Under component A: (i) completion of works for small town water supply systems for which detailed designs had been completed and contracts awarded or for which detailed designs had been completed and evaluation of tenders were completed under the parent project; completion of the drilling of 250 boreholes for which contracts were at tendering stage; (ii) completion of the detailed designs and tender documents for the other water supply systems for which the detailed designs had not been completed to date; (iii) the use of project proceeds to cover the five percent counterpart funding that was originally to be paid by beneficiary DAs, as requested by the Government of Ghana; (iv) and, installation of solar pumps on some of the small town water supply systems instead of the grid powered pumps to reduce operational costs; • Under component B: (i) provision of support for District Environmental Health Officers (DEHOs) and the Regional Health Environmental Officers (REHOs) for the campaign to construct household toilets with the aim of attaining ODF status in an additional 490 communities; and, (ii) direct support to households for the construction of 20,000 additional household toilets; • Under component C: (i) further logistical support for rolling out the Sector Information System; and, (ii) capacity building support for the Ministry of Sanitation and Water Resources and the beneficiary Regional Coordinating Councils (RCCs), Metropolitan, Municipal and District Assemblies and support for sanitation campaigns to assure achievement of targets and to improve sustainable operations and maintenance in the sector. Other Changes 21. The SRWSP project was first restructured on June 27, 2016 to extend the project closing date by 12 months from June 30, 2016 to June 30, 2017. A second restructuring for the SRWSP project occurred in June 2017, recording a 6-month extension of closing date from June 30, 2017 to December 31, 2017 to provide time for signing of the Credit Agreement for the Additional Financing. 22. The Additional Financing (AF) for SRWSP Financing Agreement (US $45.7 million equivalent) was signed on November 29, 2017 with an original closing date of December 31, 2019. The SRWSP project was last restructured in December 2019 to extend the project closing date by 6 months, from December 31, 2019 to June 30, 2020. 23. The Project was originally designed for six regions namely: Northern, Upper East, Upper West, Brong Ahafo, Central and Western. With the creation of the new administrative regions in December 2018, the Northern region was divided into three regions, (Northern, North East and Savannah); Brong Ahafo into three regions, (Bono, Bono East and Ahafo); and the Western area into two regions, (Western and Western North). As a result, the number of beneficiary regions increased from six to eleven, covering the same geographical area and with the same number of beneficiaries while increasing the number of implementing entities. Rationale for Changes and Their Implication on the Original Theory of Change 24. The first extension of the project (with 12 months, from June 30, 2016 to June 30, 2017) aimed at ensuring that all outstanding activities and works under the project, including the installation and testing of the completed systems were successfully carried out. It also aimed at fully utilizing some savings that had been made on finished works to properly complete some of the water supply systems that were behind schedule (the design of water services had been underestimated and resulted in cost overruns implying that several subprojects were not completed) and at improving the situation for the sanitation component which was lagging far behind the project Page 11 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) target. The second extension (with 6 months, from June 30, 2017 to December 31, 2017) provided the necessary time for signing of the Credit Agreement for the Additional Financing. 25. The AF SRWSP (US$45.7 million equivalent) extended the project closing date to December 31, 2019 and was supposed to finance the cost of completing the remaining contracts for works and services under the SRWSP which could not be executed as a result of cost–overruns incurred during project implementation due to higher than initially estimated expenditures. Up to that point, the project had made some good progress on water supply (achieving the targets related to rural and small town water supply), but had lagged on the sanitation and hygiene component which encountered mixed results (just over 50 percent of the target population had been covered). The AF was designed to assist Ghana in achieving the Sustainable Development Goals (SDG) related to equitable access to safe and affordable water and adequate sanitation for all by 2030, by putting an emphasis on sanitation, given the need to accelerate progress on achieving the project’s sanitation and hygiene targets. 26. The last restructuring occurred in December 2019 to extend the project closing date by 6 months, from December 31, 2019 to June 30, 2020, due to the completion risk on important contracts for small-town water supply in the Northern and Northeast regions. The project had encountered delays in the launch and implementation of project activities in the Northern and Northeast regions, following the vandalism or destruction of boreholes during local communal conflicts. Such delays had pushed completion of some of the contracts too close to the project closing date, with no buffer to accommodate possible slippages and adequate transfer of assets to operators. 27. The changes entailed within the restructurings and AF did not have any implications on the original theory of change. II. OUTCOME A. RELEVANCE OF PDOs Assessment of Relevance of PDOs and Rating 28. The rating of the relevance of the PDO is High. The project development objectives have remained highly relevant and consistent relevant to Ghana’s development priorities. Increasing access to drinking water supply and improved sanitation in rural areas have been national priorities for the Government of Ghana from the 1990s to the present. These priorities were embedded in the National Water Policy, the Environmental Sanitation Policy and were underpinned by the principles enunciated in the Ghana Poverty Reduction Strategy (GPRS 2000-2005 and GPRS-II 2006-2009), the National Medium-Term Development Policy Framework (2010-2013) and the Ghana Shared Growth Development Agenda. During the project implementation lifetime, the GoG set up the new Ministry for Sanitation and Water Resources, its name indicating the importance of access to sanitation, which considerably lags behind access to water supply across the country. 29. The PDOs were also highly relevant for Ghana in its endeavor to achieve the UN development Goals (MDGs), as well as the Sustainable Development Goals (SDGs) related to equitable access to safe and affordable water and adequate sanitation for all by 2030. Furthermore, the PDOs are also aligned with the “Africa Water Vision for 2025” of the New Partnership for Africa’s Development and championed by the African Minister’s Council on Water since 2004. 30. The project development objectives have also remained relevant and consistent with the World Bank’s Ghana Country Partnership Strategy (CPS) for FY2013-2018 (Report No. 76369-GH), which inter alia, focuses on Page 12 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) improving health outcomes in a sustainable manner. The CPS makes specific reference to the country’s lack of progress for improved sanitation and indicates that access to safe water and sanitation would reduce the outbreak of diseases such as cholera, diarrhea and other communicable diseases, which would lead to improvements in child health. 31. The World Bank’s Ghana Systematic Country Diagnostic (SCD - Report No. 132010-GH) published in 2018, showcased that the country’s mortality rates attributed to poor water and sanitation access are significantly higher than the country’s income level would suggest. The SCD indicated that poor health outcomes are exacerbated by poor access to water and sanitation and that strategic investments in sanitation were further needed. Improved water services are also an integral part of the World Bank’s twin goals of ending extreme poverty and promoting shared prosperity. Improving access to water supply reduces the incidence of water- borne diseases 6, leads to time savings, and increases productivity, with significant and direct benefits to the poor, women, and girls. The beneficiary regions under the project have high rates of poverty and the completion of SRWSP aimed to contribute to poverty alleviation. Lastly, provision of safely managed water, sanitation and hygiene (WASH) services and application of good hygiene practices are central to an effective COVID-19 pandemic response and to building resilience to future risks. Thus, the project also contributed to mitigating the spread of COVID-19 and building resilience against future disease outbreaks. B. ACHIEVEMENT OF PDOs (EFFICACY) Assessment of Achievement of Each Objective/Outcome 32. The PDO was expected to have three main outcomes: (a) expand access to water supply services; (b) expand access to sanitation services; (c) ensure sustainable water supply and sanitation services. The original PDO was not modified during project implementation. The overall structure and objectives of the project components were also not changed during the restructurings. The Additional Financing increased the level of ambition for some of the target outcomes (the target values of some indicators were revised upwards, as presented above in Table 2). Thus, the operation was assessed based on the more ambitious revised outcome targets and a split rating was not applied, in line with the Bank’s guidance ICR for IPF Operations issued March 2, 2020 (para. 60, number ii). 33. PDO 1: expand access to water supply services. Achievement – High. This objective was measured by three main outcome indicators: (i) number of people in project area with access to improved water supply; (ii) number of direct project beneficiaries 7; (iii) percentage of female direct project beneficiaries. The Project increased access to safe drinking water supply to 94 districts in 11 regions of Ghana. Overall, 1,356,340 people were direct project beneficiaries, significantly exceeding the revised target of 800,000, gaining access to improved water supply. The Project financed 1,349 new borehole water supply systems, above the target of 1,200, and rehabilitated 376 orphan boreholes, above the target of 300. The project also financed the construction of 75 new small town water systems, exceeding the target of 60, and constructed 58 new operational mechanized boreholes, marginally below the target of 60. The project also financed the rehabilitation of 15 former GWCL systems transferred to communities, meeting the target of 15, and 9 new community water systems fed from GWCL, exceeding the target of 5. Overall, the boreholes with hand pumps served a population of 524,700, while the small town water supply systems served 831,640 people (with a combined total of 1,356,340 people benefitting from access to water 6 WHO (2007) Combating waterborne disease at the household level / International Network to Promote Household Water Treatment and Safe Storage, World Health Organization. 7 Direct project beneficiaries were initially considered those that would get access to improved water supply, improved sanitation or both (no double counting). In the end, the higher number (those with access to improved water supply) was chosen for this assessment. Page 13 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) supply). Out of the total 1,356,340 direct project beneficiaries, 51.5% are estimated to be female, based on the gender demographics of Ghana from the Ghana Living Standards Survey 7, 2019 (approximately 698,515 women). 34. PDO 2: expand access to sanitation services. Achievement – High. This objective was measured by two main outcome indicators: (i) number of people in project area with access to improved sanitation; (ii) number of communities in project area declared free of open defecation. The total number of people provided with access to improved sanitation services in the project area was 672,676, exceeding the target of 600,000. 56,228 improved latrines were constructed by households under the project against a target of 40,000. A total of 568 institutions (schools and clinics) were provided with improved latrines (out of which 437 were provided under the original SRWSP), exceeding the target of 400. These latrines catered separately for pupils and teachers and had gender separated toilet blocks. Despite an initial low demand for construction of household toilets, the enhanced behavioral change communication, using resident District Environmental Health Officers deployed to work in the beneficiary District Assemblies to undertake a higher level of community outreach, led to a total number of 1052 communities declared Open-Defecation Free (ODF) (of which 105 communities were from the original project and 947 from AF), far exceeding the project target of 550 communities. Additionally, 1,168 communities received awareness information on personal hygiene practices and environmental sanitation. In the communities where the project activities took place, the beneficiaries were trained in hygiene practices and linkages between sanitation, water and diseases, thus increasing the likelihood of attaining the full health benefits of the investments. Qualitative assessments of the beneficiaries conducted in the household survey indicated that less than 7% of the children under five years experienced symptoms of recent diarrhea (in a 24-hour period during two weeks before the survey) in some of the communities where the project operated, suggesting that incidence of diarrhea had gone down for children in that age cohort compared to previous years, and attributing this to the sanitation and hygiene campaigns and the ODF achievement. The beneficiary assessment also highlighted benefits regarding averted productive loss (90% of respondents indicated a significant increase in access to potable water and considerable savings in travel time to fetch water after the installation of new water sources, resulting in more time for revenue generation activities for adults and more time spent studying for school children) and cost savings on health care in general 8. 35. PDOs 3 and 4: ensure sustainable water supply and sanitation services. Achievement – Substantial. The distinction between PDO 3 and 4 was introduced to ensure a balance between the water supply and the sanitation and to capture the project accomplishment with regards to improving sanitation services which substantially contributed to the overall PDO of the project. This objective was measured by two main outcome indicators: (i) reliability of water supply services in project area; (ii) water systems in project areas with ratio of revenues over operation and maintenance costs (including depreciation) equal or greater than 1. The achievement of the target with respect to reliability of water supply services under the project area i.e. access to water supply for a minimum of 16 hours per day is 1.00 or 100%. The achievement of the target with respect to water systems with ratio of revenues over operation and maintenance costs (including depreciation) equal or greater than 1 could not be determined by the time the project closed. The main reason for this was that several of the water systems were just completed towards the end of the project and at that time the government was providing free water for population due to the exceptional circumstance of the on-going COVID-19 pandemic (from April 2020 to December 2020 and beyond), a situation which was expected to last for a while even after the project closure date. The beneficiary assessment indicated that the default rate of water users was significantly higher for water 8 A recent study conducted on the cost of illness for childhood diarrhea in low- and middle-income countries estimated that inpatient caretakers lose 8.4 productive days and outpatient caretakers lose 4.3 productive days: Baral et al. BMC Public Health (2020) Cost of illness for childhood diarrhea in low- and middle-income countries: a systematic review of evidence and modelled estimates, available at https://doi.org/10.1186/s12889-020-08595-8. Page 14 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) systems that utilized a monthly flat rate for water tariffs when compared with Pay-As-You-Fetch modality. To address this issue and enhance sustainability, the project successfully pioneered the introduction of innovative “smart” technologies, such as token activated pre-paid public water stand pipes and remotely monitored and controlled solar-powered pumping systems, reducing the risk of insufficient funds to keep the water systems running and contributing to more cost effective and efficient operation. The sanitation did not have a specific sustainability linked indicator. However, the project successfully introduced Digni-Loo 9 toilet slabs as a sustainable, innovative and well-received solution. The Digni-Loo is a durable, affordable plastic slab that serves as an alternative basic sanitation option for households, being also hygienic (easy to install, clean and maintain) and sustainable (easily removed and relocated once the pit is full). 36. Furthermore, to enhance sustainability of both the water supply and sanitation services provided, the project significantly strengthened key State and Local government institutions to effectively execute their responsibilities. For this purpose, the project supported the establishment of management systems (by providing offices and other facilities), while CWSA appointed core operational staff, deploying 130 persons including engineers, accountants, and community relations officers to 23 towns to start the professional management of the newly constructed systems. Institutional strengthening also involved capacity building, trainings (for planning, design, monitoring and management of water and sanitation services), technical assistance and logistical support for various stakeholders, such as the Ministry of Local Government and Rural Development (with the Local Government Services and the Environmental Health and Sanitation Directorate), the Regional Coordinating Councils (RCCs), and particularly the District Assemblies (with their technical units, District Works Departments) and the District Water and Sanitation Teams. The beneficiary’s assessment of decentralized government structures, including the District Assemblies (DAs), revealed overall strengthened local capacity to implement, monitor and supervise water supply and sanitation schemes in rural communities and small towns. However, the SRWSP Beneficiary Assessment highlighted some challenges around a few cases of inadequate oversight of water systems by some of the DAs, with potential risk of systems degradation. Thus, during project implementation, the idea of CWSA directly operating and managing the small town water supply systems was advanced as a potential solution to address these issues and to enhance financial sustainability, and it seems to have gained the support of the Government, as the proposed reforms were being pursued at the project closure date. Adopting the necessary reforms was expected to entail a positive outlook for a sustainable servicing of rural water supply and sanitation. Contributing to this PDO, the project also aimed at establishing a robust Sector Information System (SIS) to facilitate information sharing, coordination, and to further enhance M&E roles among water and sanitation actors. While the Additional Financing aimed to support the operationalizing of the SIS, this specific goal did not materialize before project closure. 37. The achievement of both long-term objectives was on track at project closure. The overachievement of both the water supply and sanitation components led to improved health and hygiene practices, as well as human development and indirect economic benefits. The project also helped establish stronger institutions, enhancing the capacity of the implementing agencies to sustainably manage, operate and monitor water supply and sanitation schemes in rural communities and small towns. According to beneficiary assessments, the O&M of the new facilities were functioning well, with teams monitoring the performance of the water supply systems, and caretakers and area mechanics providing maintenance services, including provision of fast-moving spare parts. All the solid achievements with the institutional strengthening form the basis of a broader longer-term framework that will enhance sector sustainability going forward. 9 https://www.globalcommunities.org/publications/Global%20Communities_PSE_case%20study_Digni-Loo.pdf Page 15 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Table 3. Achievement of the PDO-level Indicators Share of Actual Rating Achievement Targets Results of PDO PDO Indicators (Actual Achievement Achieve Results/Targets) ment Original Revised By ICR Original Revised Number of people in project Expand area with access to improved 600,000 800,000 1,356,340 226% 169.5% access to water supply water Number of direct project High 600,000 800,000 1,356,340 226% 169.5% supply beneficiaries services Percentage of female direct not 52 51.2 98.5% n/a project beneficiaries revised Number of people in project not Expand area with access to improved 600,000 672,676 112% n/a revised access to sanitation High sanitation Number of communities in not services project area declared free of 550 1,052 191% n/a revised open defecation Reliability of water supply not Ensure services in project area [average 16 16 100% n/a revised sustainable hours of service per day] water Water systems in project areas Substan supply and with ratio of revenues over tial not sanitation operation and maintenance 1 n/a n/a n/a revised services costs (including depreciation) equal or greater than 1; Justification of Overall Efficacy Rating 38. The project’s overall efficacy rating is considered Substantial as the achievement of two of the projects’ objectives was high (with most targets being substantially exceeded) the one related to sustainability was substantial, with a likelihood of improvement once reforms are completed. C. EFFICIENCY Assessment of Efficiency and Rating 39. The initial project closing date was June 30, 2016, which was extended to June 30, 2020 (through extensions and additional financing). The four-year extension of implementation through the US$ 45.7 million additional financing had implications on the return on investment due to increased costs and delayed project benefits. However, delays in actual project timeframe vs. originally planned are not always inefficient, such as this case that resulted in net cost efficiency gains, and especially noting that beneficiaries ultimately reached significantly exceeded original targets. The project has exceeded its revised end program targets both in terms of people provided with access to improved water supply (169% of the revised targets), people provided with improved access to sanitation services (112%), as well as well as communities who attained ODF (191%). Additionally, the efficiency analysis (Annex 4) indicates that the actual expenditures for each component compared with the Page 16 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) respective beneficiaries showcases that the project was more cost effective compared to the assumptions at appraisal and at the restructuring (additional financing) stage. The actual per capita cost for provision of improved water supply services at completion was US$ 62.83, which is lower than US$ 79.0 estimated for the original project and US$ 93.3 million revised at AF. 40. An ex-post cost-benefit analysis (CBA) was conducted, following the same methodology and basic assumptions used at appraisal and AF. The scope of the CBA conducted at appraisal and project closure was limited only to the financial returns of the water supply interventions, excluding the sanitation interventions (which had indirect benefits and were not revenue generating services) and the indirect costs and benefits of the project. At appraisal and additional financing, the financial return of the project was measured by its net present value (NPV) and internal rate of return (IRR) using a 12% discount rate and 15 years of economic life for the water supply schemes. The CBA at project completion revealed the project intervention is still financially viable as demonstrated by positive NPV amounting to US$ 7.54 million and IRR of 17.3%, which is greater than the discount rate. While the return on investment at completion is lower than the estimates at the original project (IRR of 20.5%) it is higher than the estimates at the additional financing stage (IRR of 11%). 41. The positive NPV estimated at completion and the IRR higher than the discount rate shows that despite the extension of the project duration for 4 years and the cost overrun which resulted in an additional financing of US$ 47.5 million, the project interventions for water supply were found to be financially viable. This finding may signal that the impact of cost overrun and delayed benefits resulting from the prolonged implementation was compensated by over achievements of the PDO and intermediate result indicators. While the project was financially viable when aggregately considered, it conceals the financial status of each town as there are in-built cross-subsidies in the analysis. The ex-post cost-benefit (CBA) analysis did not show whether each small town will recover the cost of operations and maintenance from the current tariffs. The beneficiary assessment reported that a few towns, particularly smaller ones, were unable to cover their O&M cost from the current tariffs. The same assessment suggested that this situation could be offset if CWSA would take over the operation and maintenance of all the small town water systems as part of the on-going national reforms at the time the project closed, and would cross-subsidize across the water systems. To support this and GoG’s overall reform effort, an institutional assessment study to review the WASH sector policy, institutional and regulatory aspects and recommend measures was started under the Bank financed Greater Accra Metropolitan Area Water and Sanitation Project (P171620). 42. Under the sanitation component, 672,676 people have benefited from the sanitation intervention through promotion of good hygiene and sanitation practices, support for the construction of latrines in homes, and the construction of institutional latrines in selected schools and clinics, as well as activities aimed at behavioral change to bring about ODF status in the communities. Though this component was not included in the CBA analysis, the per capita cost estimated at completion showed that it is cost effective compared to the revised resource allocation and targets. The actual per capita cost for provision of improved sanitation services at completion was US$ 31.3, which is slightly higher than the US$ 27.7 estimated for the original project and significantly lower than the US$ 48.2 revised at AF. 43. Significant exchange rate fluctuations occurred during project implementation leading to local currency depreciation and price fluctuations that negatively affected contractors in terms of financial returns, sometimes leading to a lower quality of equipment supplied. The initial low contractor financial capacity created delays and slowed down implementation progress; however, such problems were resolved during the AF, by selecting more competent contractors for the civil works construction and using reputable subcontractors for ancillary works. The exchange rate fluctuations also affected the US$/SDR exchange rate which resulted in cost savings of about Page 17 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) US$2 million. These funds were used to finance some of the outstanding small town water supply systems or construct additional household toilets which contributed to the increased number of ODF communities. 44. There are several potential benefits that were not factored into the cost-benefit analysis both at completion and at appraisal. These include improved health conditions due to the reduction of water borne diseases 10 (as it is likely for an individual to contract water borne diseases particularly by drinking water from polluted and contaminated sources), additional income from the productive use of time saved in fetching water, improvements for the environment due to a reduction in open defecation and increased enrollment and reduction in school dropout rates (including increased punctuality of children in school with water much nearer to their homes). Therefore, the estimated benefits from the project are considered conservative, and it could be reasonably be assumed that the actual benefits were higher in the end. Lastly, the project has also been very relevant in the context of the COVID-19 pandemic fight as shown through the hygiene hand washing with soap campaigns, provisions of veronica buckets, free water and other hand washing facilities to households and institutions to enable them to adhere to the hand washing with soap protocols during the pandemic. A majority of the respondents of the household survey indicated significant increase in access to safe water sources and in their level of knowledge about personal hygiene practices. All these additional benefits which are not included in the CBA demonstrate that the internal rate of return of 17.3% under-represents the actual economic benefits to society. 45. The project delivered substantially positive economic and financial benefits and has exceeded its end program targets both in terms of people provided with access to improved sanitation as well as people provided with improved water supply, despite implementation delays. Hence, the project was assessed as an acceptable investment effort in the WSS sector in Ghana warranting a “Substantial” rating for the efficiency dimension of the project assessment. D. JUSTIFICATION OF OVERALL OUTCOME RATING 46. The Relevance of the PDO is rated High, the Efficacy is rated Substantial and the Efficiency is rated Substantial. Thus, the overall outcome rating is Satisfactory. E. OTHER OUTCOMES AND IMPACTS (IF ANY) Gender 47. The project improved access to water supply and sanitation services in rural regions of Ghana, which benefited both men and women. The beneficiary assessment conducted in all beneficiary regions highlighted that 90% of respondents indicated a significant increase for access to potable drinking water and reduced travel time to water sources. However, it can be argued that the improvements in the availability of potable water within reasonable distances in communities are more significant for women as they are often the ones that deal with the burden of fetching water, cooking and washing and are also affected by the health challenges relating to the lack of sanitation, on a daily basis, especially in the rural areas of Ghana. 51% of the beneficiary assessment respondents also indicated that the project had increased access to improved latrines in the community and in schools (which included gender separated toilet blocks) and created increased awareness to personal hygiene practices and environmental sanitation. Rigorous hygiene promotion activities were undertaken including hand washing with soap. The community surveys indicated that community members (95%) practiced hand washing at critical times 10 According to Guy Hutton’s Water and Sanitation Assessment on Benefits and Costs of the Water and Sanitation Targets for the post 2015 development agenda (January 2015), access to improved community water sources, basic piped water, and piped water of high quality have an impact of reducing diarrheal disease by 34 percent, 45 percent, and 79 percent, respectively. Page 18 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) (before eating and after defecation) and this was respected especially by women and nursing mothers. As indicated by several Bank studies 11 and other institutions 12 school-aged girls may be absent or less attentive in school during menstruation due to inadequate WASH (water, sanitation and hygiene) facilities, affecting education. The project responded to this challenge by providing equitable access to safe water, sanitation and hygiene in schools. The SRWSP also incorporated the concept of changing rooms in the design of some of the school toilet blocks, which was aimed at providing female pupils with access to a changing room during their menstrual period and the beneficiary assessment indicated that the adolescent girls using the changing rooms were positive about them. 48. Women constituted more than half of the membership of the Water and Sanitation Management Teams (WSMTs), while most of the treasurers of the WSMTs were women. Thus, inclusion of women in the management and operation of water and sanitation services enabled greater gender balance in critical decision making at the household and community levels. 49. As part of the safeguards process, community awareness sessions have been conducted. Particularly useful were the pre-construction briefings, which were beneficial especially to girls and women regarding their relationship with construction workers. This has helped to educate girls and women on their sexuality and provided advice on avoidance sexually transmitted diseases and unwanted pregnancies. Institutional Strengthening 50. The institution strengthening component of the project was aimed at ensuring enhanced sustainability of water services through the strengthening of State and Local government institutions to effectively execute their responsibilities in the water supply and sanitation sector. This involved extensive capacity building activities, trainings (for planning, design, monitoring and management of water and sanitation services), technical assistance and logistical support for various stakeholders, such as the Ministry of Local Government and Rural Development (with the Local Government Services and the Environmental Health and Sanitation Directorate), the Regional Coordinating Councils (RCCs), and particularly the District Assemblies (with their technical units, District Works Departments) and the District Water and Sanitation Teams. Spearing a reform to professionalize the water systems’ management, CWSA employed 130 persons including managers, technician engineers, accountants, water safety specialists, revenue collectors and community relations officers to 23 towns to manage the newly constructed systems. 51. The extensive capacity building of the DAs project teams (responsible for project identification and implementation at the district level) and other personnel in the sub-district level supported the Government’s decentralization policy. The beneficiary’s assessment of decentralized government structures, including the RCCs and DAs, revealed strengthened capacity to implement, monitor and supervise water supply and sanitation schemes in rural communities and small towns. 52. At the time of project closure, the Bank was actively supporting GoG to further undertake an institutional assessment of the WASH sector to analyze the legal, institutional and financial framework of the WASH sector, identify its inefficiencies in the pursuit of GoG’s goals and policies and propose options for policy, institutional, and regulatory adjustments. Furthermore, the Bank was also supporting GoG to prepare the WASH sector for a more programmatic approach through a national WASH program that would facilitate improved investments coordination and sector reforms. The main objective of the assignment was to update and consolidate the Water 11 World Bank (2018) Measuring the Influences of WASH and MHM interventions in Schools on Adolescent Girls’ Educational Engagement in Accra, Ghana 12 UNICEF (2013) WASH in Schools Empowers Girls' Education Page 19 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Sector Strategic Development Plan, the National Environmental Sanitation Strategy and Action Plan, other relevant WASH plans and prepare a National WASH Program Document with indicative cost break down and implementation framework for i) rural WASH; ii) urban WASH; iii) institutional development iv) M&E and v) funding. Mobilizing Private Sector Financing 53. Not applicable. Poverty Reduction and Shared Prosperity 54. Improved accessibility to rural water sources and hygienic sanitation leads to better health and general wellbeing of the population and especially the poor. In the interviewed households (as part of the beneficiary assessment) it was found that mostly women were involved in collecting water (82.4 percent), followed by female children (12.2 percent). The beneficiary assessment revealed that time savings in fetching water were significant after the installation of new water sources close to the household premises and as such the beneficiaries had more time to undertake income generating activities, while school children spent more time studying than they used to, which could result in improved academic performance. The disease burden due to water borne diseases also impacts women as they have to spend productive hours caring for sick family members, including time spent in hospitals which could have been used in income generating activities. 55. The project has supported and benefited the rural people in accessing cheaper and more reliable water services (providing targeted in-kind subsidy to the rural community in the form of reusable latrine slabs with appliances) and thus helped in improving conditions under which economic development and overall poverty reduction can take place. Furthermore, improving the water supply and sanitation services could have generated significant benefits for public health, the environment, and certain economic sectors, although these benefits may be less obvious to individuals and more difficult to assess in monetary terms. Other Unintended Outcomes and Impacts 56. An unintended positive impact of the project is the contribution to managing the COVID-19 pandemic. The project implemented a hygiene and handwashing promotion, which were considered critical elements to mitigate the spread of COVID-19. Several water supply systems were completed with the onset of COVID-19 pandemic. CWSA championed the hand washing with soap campaign in Ghana and provided veronica buckets, free water and other hand washing facilities to households and institutions to enable them to adhere to the hand washing with soap protocols. The protocols implemented by the government, especially the hand washing with soap, reinforced the hygiene education messages provided by the project stakeholders in connection with ODF attainment, with the aim of helping to mitigate the spread of the COVID-19 pandemic. III. KEY FACTORS THAT AFFECTED IMPLEMENTATION AND OUTCOME A. KEY FACTORS DURING PREPARATION 57. The project design identified clear and realistic objectives. The operation supported the continued implementation of the National Community Water and Sanitation Program of Ghana, which was coordinated and facilitated by the Community Water and Sanitation Agency. At the time, the GoG had adopted a decentralization policy for the water sector, including the establishment of the CWSA to facilitate rural water supply and sanitation Page 20 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) development. The project was prepared based on existing studies, assessments, previous sectoral lessons learned and technical meetings which informed the project objectives, components and institutional arrangements. The appraisal document described a situation of insufficient water coverage and sanitation services in the initial six targeted regions of Ghana. The underlying challenges in the water and sanitation sectors in Ghana and their relation to the overall economy as well as the level of existing services were highlighted. Given the country sector context and existing national program, the project design identified clear and realistic objectives, aimed at responding to the sector priorities geared towards increased access to sustainable water supply and sanitation services. 58. While the project design was relatively simple with three structured components whose contribution to the objectives was clear, it could have benefited from improved implementation arrangements, for example, consideration of direct support to households in the construction of toilets, a more pragmatic and enhanced behavioral change communication strategy etc.. The elapsed time between the identification mission and Board approval was only 7 months. This left limited time for the development of in-depth studies or assessments that could have further helped strengthen the project design. At the AF stage it was highlighted that the Parent Project suffered from initial poor preparation by the client as a result of inadequate due diligence; this mostly referred to the large expansion of target communities and the correspondingly larger populations (which led to cost- overruns) that could have been considered during project preparation as opposed to during project implementation. B. KEY FACTORS DURING IMPLEMENTATION 59. The project over-achieved its targets, strengthened institutions and led to the introduction of innovative smart water supply technologies and solar-powered pumping systems to address some of the issues encountered during implementation. Furthermore, the project was a cornerstone for GoG’s ambitions to further improve the WASH sector arrangements and institutions and prepare the WASH sector for a more programmatic approach through a national WASH program that would improve investments coordination and sector reforms, as pursued through the on-going World Bank technical support at the project closure. Nonetheless, the project faced several challenges that had to be resolved in order to obtain these positive results, as presented below. 60. Cost overruns. The parent project encountered cost-overruns with the rehabilitation of the water supply systems in the Northern Region, since communities had significantly outgrown the initial design capacities thus requiring a redesign of both the transmission and distribution mains. There was a need to bolster the capacities of pipelines, pumps and storage tanks in the 15 small town systems initially targeted for rehabilitation to cover the larger than estimated population and geographic dispersion of towns. Other technical issues were encountered and successfully addressed during implementation, albeit at higher than anticipated costs to ensure durability and sustainability of the installed systems:: (i) original designs using poly-tanks had to be replaced by concrete reservoirs at a higher cost in order to withstand the weather conditions in the target communities; (ii) a larger number of iron removal plants were needed for the target water supply systems as very high iron content was encountered during the exploration of groundwater source; (iii) longer than estimated pipelines were deemed necessary to connect communities located in fluoride and high saline areas; (iv) the water supply distribution mains had to be changed from PVC pipes to HDPE pipes to avoid illegal connection to the mains; and, (v) some selected communities did not have electricity from the national grid and the cost of connecting these communities to the national grid was higher than anticipated. These cost overruns justified the Additional Financing which enabled the project to complete all remaining works and achieve its targets. Page 21 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) 61. Behavioral change and affordability for sanitation. The behavioral change communication (BCC) for hygiene and sanitation awareness encountered initial bottlenecks and resulted in lower than anticipated initial demand. The behavioral change communication strategies to increase demand for the construction of household toilets were initially developed by consultancy services. However, inadequate contact between the consultants and the targeted communities led to a lower than expected demand and fewer construction of household toilets. Another reason for the low demand was the affordability concerns of the population. Overachieving sanitation targets The early encountered bottlenecks with the BCC and affordability concerns for the sanitation component were efficiently resolved to lead to an overachievement of sanitation targets. For the BCC, resident District Environmental Health Officers (DEHOs) were put in place, working in beneficiary District Assemblies where they undertook an effective and higher level of community outreach on hygiene and sanitation (triggering and sensitizing communities) and successfully monitoring the construction of household toilets. The affordability concern was solved through the provision of direct material support (the Digni-Loo slabs subsidies) to rural households, which also contributed to a significant demand and upsurge in the construction of toilets by households. Thus, the introduction of the targeted in-kind subsidy and intensive hygiene and sanitation promotion at local level through DEHOs, complemented by the simple Digni-Loo toilet slab innovative solution has made a significant difference and contributed to the over achievement of the sanitation component. 62. Sustainability. In some areas, default rates for water users were higher for water systems that utilized a monthly flat rate for water tariffs when compared with a pay as you fetch modality. To address this issue and enhance sustainability, the project successfully pioneered the introduction of innovative smart water supply technologies, such as token activated pre-paid public water stand pipes and remotely monitored and controlled, reducing the risk of insufficient funds to keep the water systems running and contributing to more cost effective and efficient operation. The solar-powered pumping systems aimed at improving operational efficiency of the small town water supply systems instead of the grid powered pumps, significantly reducing the operational costs with energy. A reform to professionalize the water systems’ management was implemented by CWSA, to ensure improved O&M services and a more sustainable delivery of the water supply services. For this purpose, CWSA employed 130 persons including managers, technician engineers, accountants, water safety specialists, revenue collectors and community relations officers to 23 towns to manage the newly constructed systems. Extensive trainings and capacity building activities were also completed. 63. DAs capacity. Despite building the technical capacity of District Assemblies in sub-project monitoring and supervision of service providers, initial progress from DAs was slow and led to delays in sub-project start-ups. The processing of payment requests from service providers was initially cumbersome and led to delays in payments to contractors and slowed down project progress. During the first years of implementation there were also some weaknesses in procurement relating to record keeping and reporting, and delays in contracts delivery by the implementing agency. However, continual capacity building for procurement for stakeholders at various levels was provided and issues were resolved. 64. Counterpart funding. During implementation, the Government subdivided some metropolitan, municipal and district assemblies, including some of the SRWSP beneficiary districts. The result is that the project ended up covering a total of 94 DAs, within the same targeted area. The DAs contribution of 5% for investments in rural and small town water supply systems was waived during an initial implementation period (DAs were expected to contribute 5% after June 30, 2012), as agreed during negotiations. However, after the waiver was over, the beneficiary DAs were recording delays with payments of the counterpart fund of 5% of the subcontracts even Page 22 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) though constructions were completed in their districts. Thus, at the request of GoG, proceeds of the project (through the AF) were used to cover the five percent counterpart funding that was originally to be paid by beneficiary DAs, to address the delays in payments. 65. Contractor capacity. Low contractor financial capacity created delays and slowed down implementation progress. Contractors could not easily acquire bank guarantees for advance payment due to unfavorable banking conditions in Ghana. For the second phase Additional Financing, lessons learnt during the parent project were applied and enhanced the contractors selection and performance. This helped expedite constructions by selecting more competent contractors for the civil works construction and using reputable subcontractors for ancillary works such as installation of water treatment units, electromechanical installations and solar power systems. 66. Highly relevant for the implementation was the full alignment between the Bank and the GoG in relation to the execution of this project, namely the Bank’s flexibility for allowing for an AF, as well as the extra time allotted for project implementation to be able to complete the targeted works. This was also a consequence of the Bank’s active prior long-term support for the water sector in Ghana which helped in establishing strong relationships and understanding. The Bank team conducted semi-annual supervision missions and provided regular, pro-active and demand-responsive ongoing implementation support to resolve any issue, as well as thematic technical assistance outside the regular missions. Progress was reported with candor in the ISRs and AMs and issued recommendations to address challenges. 67. Exchange rate fluctuations. Significant exchange rate fluctuations occurred during project implementation leading to local currency depreciation and implementation delays. Price fluctuations negatively affected contractors in terms of financial returns and therefore led to occasional implementation delays (due to contractor problems with raising money to make up short falls) while the quality of equipment supplied and works may have suffered, as some problems were reported, such as the burst pipelines experienced during the defects liability period of some of the newly constructed water supply systems. The exchange rate fluctuations also affected the US$/SDR exchange rate which resulted in cost savings of about US$2 million. These funds were used to finance some of the outstanding small town water supply systems or construct additional household toilets which contributed to the increased number of ODF communities. 68. Additional implementation challenges. The project encountered delays in the launch and implementation of some project activities in the Northern and Northeast regions, following the vandalism or destruction of boreholes during local communal conflicts in 2018 and 2019. Another reason for delays was the variation in the degree of development of regions (i.e. very low development and capacity in the northern region that affected implementation progress). These contributed to the initial extension of the closing date. However, these have not affected the overall outcome, as the project took remedial measures during implementation. IV. BANK PERFORMANCE, COMPLIANCE ISSUES, AND RISK TO DEVELOPMENT OUTCOME A. QUALITY OF MONITORING AND EVALUATION (M&E) M&E Design 69. At the time of project preparation, the team was not required to prepare a theory of change. The theory of change has been inferred from the PDO, the project components and activities as well as the results framework. The overall M&E framework focused on the construction of the water supply and sanitation infrastructure investments and in improving the implementation performance of the DAs. The results framework indicated that Page 23 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) a baseline had to be established for some indicators and the project would build on the baseline to measure achievement. The indicators were structured such that achieving the targets was directly linked to meeting the PDO. The target values of some indicators were revised upwards to reflect the greater number of people that would be covered by the investments in the selected communities, based on the changes reflected at the AF stage. 70. Most Indicators were comprehensive and relevant to the project activities and proved adequate to measure the achievement of the PDO. The PDO indicators were adequate to track the progress of the first two objectives, but moderate shortcomings were noted for the objective that dealt with ensuring sustainable water supply and sanitation services. Achievement of the target with respect to water systems with ratio of revenues over operation and maintenance costs (including depreciation) equal or greater than 1 could not be determined as there was no data available at the time of project closure, according to the Borrower’s ICR, while the sustainability of the sanitation component could have included an additional specific indicator. M&E Implementation 71. A robust supervision and monitoring framework for the project was developed. Data was routinely collected during project implementation. Where it was difficult to establish a clear baseline, the project considered the baseline to be zero and measured additionality; the achievements of the project were then based on the figures obtained. The responsibility of M&E of sub-projects at the district levels laid with the District Assemblies, who received direct guidance from CWSA. Data and information related to performance and results indicators were routinely collected during project implementation from progress reports compiled by individual DAs and submitted to RCCs and RWSTs and the databases of central and regional CWSA agencies. The District Water and Sanitation Teams (DWSTs) compiled the data and used it to prepare quarterly and annual reports on the progress of project implementation, which allowed regional project teams and CWSA to closely track progress in each district. The District Monitoring and Evaluation System (DiMES) was the official database platform of the CWSA and was upgraded to capture additional data on rural water and sanitation facilities and related services. The CWSA reported regularly on project progress to relevant institutions and the Bank by preparing and disseminating progress reports; key findings were recorded in Aide Memoires. M&E Utilization 72. The M&E system was designed to support decision-making and implementation quality. The M&E system informed the MTR and sub-sequent restructurings, helping to assess the status of the project components and the implementation progress toward achievement of the expected outcomes. The MTR reviewed the implementation issues faced by the project and agreement on an action plan for their resolution, which pushed progress forward. 73. CWSA prepared regular reports and submitted them to the World Bank, and their quality improved over time. The task team was able to modify targets during implementation (at the AF stage) based on the collected data and the M&E outcomes. 74. The project’s M&E functions and processes are likely to be sustained after project closing, and the use of the DiMES database will be continued by CWSA and the DAs. The M&E framework for the project could have benefited from the development of a comprehensive sectoral Water and Sanitation Sector Information System (SIS) to monitor and evaluate access of the population to water supply and sanitation services and the quality and sustainability of these services. However, the operationalization of the sectoral SIS was repeatedly delayed and eventually not completed prior to project closure, despite repeated recommendations received by the CWSA from the Bank team. The reason for this was the undergoing institutional reform in the sector which was supposed to Page 24 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) affect the roles and responsibilities of the key sector institutions. Due to the short time left available in the project, the CWSA and Ministry of Water Resources Works (MSWR) agreed to move the SIS operationalization to a future intervention when further institutional studies and actions would be completed. Justification of Overall Rating of Quality of M&E 75. The overall rating of the M&E system is Substantial as there were moderate shortcomings identified in the design. The project data were systematically collected, monitored by the team, reported on the need to restructure the project and informed the AF. The supervision and monitoring framework proved robust, with mostly clear and easy to measure indicators and targets which helped inform the implementation process. While there were moderate weaknesses with the M&E design for the sustainability related objective, the overall M&E system as designed and implemented was generally sufficient to assess the achievement of the objectives and test the links in the results chain. B. ENVIRONMENTAL, SOCIAL, AND FIDUCIARY COMPLIANCE 76. Overall, the project was classified as a category “B” risk project, which triggered OP. 4.01 Environmental Assessment and OP. 4.12 Involuntary Resettlement. Anticipated social impacts centered around the provision of rural and small town water systems, which among other issues, required land acquisition leading to physical and economic displacement. Consequently, Environmental and Social Management Framework (ESMF) and a Resettlement Policy Framework (RPF) were prepared, consulted upon and disclosed within six months of project effectiveness and before commencement of civil works. The RPF and ESMF for the parent project were disclosed in April 2010. Following the project restructuring and Additional Financing in 2017, the ESMF and RPF were updated to reflect changes to the project and safeguard implementation experience on the parent project and re- disclosed in June 2017. 77. During project implementation, the project was consistently rated moderately satisfactory or above on safeguard issues. In order to minimize and/or avoid destruction of assets, properties and businesses which can negatively affect the livelihoods, the project team resorted to voluntary acquisition of communal lands from traditional authorities and district assemblies for the construction of a couple of small town water systems and institutional latrines. Nonetheless, through involuntary land acquisition, twenty-three (23) site specific Abbreviated Resettlement Action Plans (ARAPs) were prepared as required by OP4.12 and in line with the project RPF to guide compensation issues related to affected properties or livelihoods including lands, farms, stores and other income generating activities. Grievance Redress Mechanisms (GRM) were functional across all project locations and proactive efforts were made to resolve all grievances received before the project end date. The project grievance redress system was also designed to receive and resolve cases relating to Gender Based Violence. The final project safeguard audit report underscored the increased use of local labor during project implementation. 78. The relevant safeguards staff in all the 11 beneficiary regions received appropriate and regular training and capacity building in all the areas relevant to safeguards implementation. Training sessions and workshops covered the proper identification of and consultation with Project Affected Person (PAP), grievance notification and resolutions, compensation payments, monitoring of project implementation based on mitigation measures stated in ESMPs, preparation of monitoring reports, among others. The robust system maintained by the project team did not only address the adverse social impacts of the projects but also helped to extend complimentary development benefits to the project affected communities. Project beneficiaries and contractors were also trained on aspects of safeguards pertaining to health and safety. 79. The project team decided to address the unstainable energy cost for running the community water systems (from the use of electrical energy pumps) by installing solar powered pumps. During implementation the project team Page 25 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) also decided to enhance the maintenance regime of the water pipelines by replacing PVC pipelines with the more durable and leak resistant HDPE pipelines to prevent frequent rehabilitation and maintenance works and support resource conservation. 80. Financial Management (FM) was generally rated moderately satisfactory, while the FM risk was considered moderate. Independent Government audits were conducted annually at CWSA Head Office and this included transactions for the entire project including project activities at the districts. The project (through CWSA) was in compliance with submitting acceptable periodic financial reports, including audits, albeit with occasional minor delays in meeting deadlines. The external auditors noted some internal control and accountability issues, most of which have been rectified. The most recent audit report for the year ending December 2019 was received in September 2020, which was after the submission deadline of six months after the end of the fiscal year. This was however accepted by the Bank given the restrictions on social activities and delays caused by the COVID-19 pandemic. The review of the audit report and the management letter did not highlight any significant internal control deficiencies or accountability issues during the audit assignment and the issues noted were relatively minor. 81. There were no major issues with compliance with procurement procedures. The project started with a substantial procurement risk rating related to the large number of procuring entities under the project (as the District Assemblies played the leading role in subproject implementation, while CWSA coordinated the overall program and provided technical support and advice). By the AF stage, there were some weaknesses observed in procurement relating to record keeping and reporting, and delays in contract delivery by the implementing agency. Continual capacity building for stakeholders at various levels was provided. While there were occasional procurement delays during the project implementation, procurement was rated moderately satisfactory throughout most of the implementation of the project. C. BANK PERFORMANCE Quality at Entry 82. The strategic relevance of the project was well articulated at entry and closely matched client priorities. The project followed the principles and the approaches of the National Water Policy (addressing a very critical need for improving access to water and sanitation) and was in line with the Bank’s committed to contributing to the development of the rural water supply and sanitation sector in Ghana, as reflected in the Country Assistance Strategy. The project was also aimed at improving sustainability of the sector by supporting decentralization of responsibilities to the district assemblies. 83. The Bank mobilized a relevant mix of expertise to incorporate appropriate concepts during the project design stage. The project preparation and appraisal adequately incorporated lessons learned from previous operations (e.g. making the District Assemblies responsible for subproject implementation, management and oversight of operation and maintenance of the small town and community systems; developing a Community Led Total Sanitation campaign for hygiene-promotion; including development of a Sector Information System for water and sanitation; enhancing the capacity of DAs and key stakeholders). The technical, safeguards and fiduciary aspects were also adequately addressed while implementation arrangements were made for the project. 84. The design of the sanitation component could have benefitted from additional studies and assessments (to better understand and define the works and optimal implementation arrangements) to prevent the low achievement of delivery of household latrines and ODF status for the rural communities during the first years of the implementation phase. The initial assumption that the promotion of Community Led Total Sanitation (CLTS) will create adequate awareness and generate demand for sanitation solutions did not materialize well during Page 26 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) implementation, as constant follow-up was required, as well as targeted support to the poor families. The population assumptions for some of the targeted areas proved inadequate leading to underestimated capacities of some of the water system and consequential significant cost overruns. These issues were addressed and resolved during the Additional Financing. 85. The risk assessment was adequate and candid and was complemented by relevant proposed mitigation measures, including needs for additional trainings and capacity building (for financial management, procurement, safeguards etc.). Sustainability was highlighted both as an important outcome and risk and could have also benefited from more in-depth assessments at the design stage. 86. The overall rating of the Quality at Entry is Moderately Satisfactory, as there were moderate shortcomings at entry level, as described above. Quality of Supervision 87. The World Bank conducted adequate semi-annual supervision missions and provided regular, pro-active and demand-responsive ongoing implementation support, as well as thematic technical assistance outside the regular missions, while deploying multidisciplinary teams with expertise in procurement, FM, safeguards, project evaluation to review relevant implementation documents. It reviewed audit reports and supported the procurement activities and supervised the safeguards, trained and tasked the responsible stakeholders to better report on safeguards and ensure safeguards compliance. It proactively identified and resolved issues related to the achievement of relevant development outcomes, while client capacity challenges were progressively addressed. By project completion, the fiduciary and safeguards capacity of the client had improved. 88. The Bank team reported with candor (while sometimes conservative) on the progress as evidenced in the ISRs and Aide Memoires which reflected project challenges and issued recommendations to address them. At MTR, a series of challenges with cost overruns on sub-projects, slow implementation and inadequate training to local Government entities, as well as challenges with mobilizing counterpart funding from DAs were identified. Following the MTR, the World Bank team was instrumental in carrying out relevant changes to resolve some of these constraints. Nevertheless, the project duration had to be extended for a year due to implementation delays, prior to the AF. Although several suggestions were made and successfully addressed the various challenges identified during project implementation (such as introducing solar power and smart water supply solutions to enhance the sustainability of operations) the client did not always implement the recommendations in time. One such example is the Sector Information System which was not operationalized prior to project closure, despite the repeated recommendations received by the CWSA from the Bank team. During the last year and a half of implementation, the Bank and the project team made a big push to achieve the project objectives, as shown by the consistent improvement in the disbursement. The Bank extended the AF project closure date by six months to allow enough time to complete the last remaining ongoing works. Thus, construction of the remaining works was substantially completed by the project closure. The Bank also recommended measures to be put in place by the CWSA to the ensure post project operation of the monitoring and evaluation systems. 89. The overall rating of the Quality of Supervision is Satisfactory as there were minor shortcomings during the implementation. Justification of Overall Rating of Bank Performance 90. The World Bank team effectively and satisfactorily assisted the implementing counterparts (it undertook proactive actions and provided useful recommendations during implementation, at restructuring and AF) in achieving consistent progress, moving the project from initial delays and shortcomings to a successful project. However, the project experienced moderate shortcomings at the preparation stage and could have incorporated a better Page 27 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) assessment at entry level on how to align the project ambition with the counterpart implementation capacity to improve its capacity to implement and ensure sustainability of operations. Thus, the overall Bank performance is rated Moderately Satisfactory. D. RISK TO DEVELOPMENT OUTCOME 91. The project achieved its desired outcomes of increasing and ensuring access to water supply and sanitation services in rural communities of Ghana. The project also contributed to a strengthened local capacity, governance and decentralization to manage rural and small town water and sanitation facilities and led to improved health and hygiene practices, contributing to human development and increased productivity. 92. The main risk to the development objective is the sustainability of the constructed systems, as long-term sustainability of water supply systems installed in Ghana has been a recurring challenge over the years. The sustainable operation and management of the completed water supply schemes beyond the project closure will be dependent on adequately staffed and resourced institutions, as well as adequate resources, including optimal financing and efficient supply chains of spare-parts for the facilities. To address this, the Bank was further engaged (at the time the project closed) in supporting GoG to analyze the legal, institutional and financial framework of the WASH sector and identify options for policy, institutional, and regulatory adjustments. 93. The parent project Beneficiary Assessment Report indicated some challenges centered around inadequate oversight of water systems by the DAs with the risk of eventual rundown or collapse of the systems. There were challenges with supply chains for handpump spare parts, borehole replacement and inadequate handpump mechanics in some communities. To address these issues, the management of the small town water systems constructed under the AF-SRWSP was taken by CWSA, with a more positive outlook for sustained services to small towns. However, some of the point sources and small town water systems constructed under the Parent SRWSP were still managed by the WSMTs. The latest Beneficiary Assessment Report also highlighted potential issues with proper record keeping for some of the water systems operated by WSMTs. It will be particularly important that the GoG pursues the operationalization of the robust Sector Information System to facilitate information sharing (including performance of water supply and sanitation facilities sector investments, and O&M funding requirements), coordination, and to enhance M&E roles among water and sanitation actors. V. LESSONS AND RECOMMENDATIONS 94. A lack of thorough project preparedness and due diligence at appraisal led to implementation delays, which were later addressed during implementation. Some of the issues causing the delays in achieving targets (such as the low achievement of delivery of household latrines and ODF status for the rural communities during the first years of implementation for the parent project) could have been considered during project preparation, rather than tackled at AF stage. Rigorous project preparation and pre-project due diligence, including a more careful appraisal of targeted beneficiaries, cost estimates and prioritization of sub-contracts helps strengthen assessments of scope and water quality challenges, improving implementation arrangements, optimal allocation of project resources and avoiding cost overruns. 95. Technology improvements and innovative methods could help enhance access to affordable and sustainable water and sanitation systems. A problem with the small town water piped systems observed over the years had been the availability and cost of electrical power for the operations of the systems. For a typical small town piped system, the cost of power supply could represent 50% or more of the total operational costs. To address this issue during implementation, the project introduced solar panels aimed at improving operational efficiency using hybrid Page 28 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) pumps on some of the small town water supply systems instead of the grid powered pumps, significantly reducing the operational costs with energy and enhancing the sustainability of the water systems. Scaling up solar energy installations in all the water supply systems could ultimately serve the poor and vulnerable communities by reducing the tariffs due to lower energy costs. Smart taps to the public water posts were also installed and the CWSA raised awareness to the beneficiary communities on their use. For sanitation, Digni-loo slabs were provided under the project to assist low income communities in the construction of household toilets. The Digni-Loo toilet slabs were introduced as a durable, affordable plastic slab that serves as an alternative basic sanitation option for households, being affordable, hygienic (easy to install, clean and maintain) and sustainable (easily removed and relocated once the pit is full). The smart taps with tokens, the solar powered hybrid pumps, the Digni-Loo slabs were all project innovations that were very well received by the beneficiaries and enhanced the sustainability of the systems. 96. An effective fee collection system for full cost recovery including depreciation is essential for the long-term sustainability of the water systems. The beneficiary assessment noted that in some areas the default rate of water users was significantly higher for water systems that utilized a monthly flat rate for water tariffs when compared with a Pay-As-You-Fetch modality. These difficulties have been addressed during the implementation of the AF with the installation of pre-paid smart meters for standpipes. Converting stand-pipes smart meters reduced the risk of insufficient funds to keep the water systems running for the short and medium term and might ensure system replacements in the long-term. By pioneering the introduction of innovative smart water supply technologies, such as token activated pre-paid public water stand pipes and remotely monitored and controlled solar-powered pumping systems, a more cost effective and efficient operation was ensured, improving positive externalities and enhancing sustainability. These solutions could be easily replicated in targeted poor areas of the world. 97. Pragmatic behavioral change communication (BCC) strategies delivered by relevant stakeholders, coupled with the provision of material support proved vital for achieving open defecation free (ODF) status through CLTS. The parent project supported consultancy services for BCC strategies to increase demand for the construction of household toilets and contribute to achieving ODF. However, despite the high investments in consultancy services for BCC, there was a lower than expected initial demand and correspondingly fewer constructions of household toilets through the CLTS. The limited results were a result of the inadequate contact between the consultants and the targeted communities, as well as lack of interest and financial resources for some of the households to construct toilets. The situation was remedied during project implementation by employing a new and more pragmatic strategy of putting in place resident District Environmental Health Officers (DEHOs) working in beneficiary District Assemblies where they undertook an effective and higher level community outreach (triggering and sensitizing communities) and successfully monitored the construction of household toilets, significantly increasing the number of communities attaining ODF status. This was coupled with the provision of material support (such as the Digni-Loo slabs subsidies) to rural households, which led to a significant demand and upsurge in the construction of toilets by households, positively impacting the CLTS. Thus, it may be concluded that longer and continuous BCC contact time, coupled with the provision of material support to rural households greatly improves CLTS and the likelihood that the households will construct improved toilets. In addition, the education on the dangers of open defecation and on benefits of hand washing at critical times effectively increased knowledge on the health impacts of poor sanitation and hygiene practices. 98. Decentralized project implementation models should be coupled with strong Monitoring and Evaluation systems that help identify shortcomings, trigger remedial actions and keep a project on track. The project comprised a decentralized implementation model, with DAs and RCCs playing leading roles in subproject implementation, while the CWSA coordinated the overall program and provided professionalized technical Page 29 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) support. The project built extensive capacity for the decentralized local government institutions and other sector stakeholders to implement, monitor and supervise water supply and sanitation schemes in rural communities and small towns. The District Monitoring and Evaluation System (DiMES) was the official database platform used by the CWSA and stakeholders for M&E and was upgraded during implementation to capture data on the rural water and sanitation facilities and related services. The use of good monitoring and evaluation data from the results framework helped prepare the project restructuring (extensions) during implementation and informed the preparation of the AF. The regular and timely M&E reports informed the project teams on the shortcomings (such as the cost overruns for the sanitation component) during the project implementation and have indicated the need for the additional financing to reach the project objectives. However, it is essential to build a robust M&E system at the project preparation, train the relevant staff and incorporate the results framework within the institutional M&E system for timely reporting and sustenance of monitoring efforts beyond project closure. Moreover, developing a broader sector wide monitoring solution (such as the proposed Sector Information System which was not completed), would lead to a more programmatic engagement in the sector. . Page 30 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) ANNEX 1. RESULTS FRAMEWORK AND KEY OUTPUTS A. RESULTS INDICATORS A.1 PDO Indicators Objective/Outcome: Number of people with access to improved water supply under the project Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Direct project beneficiaries Number 0.00 600,000.00 800,000.00 1,356,340.00 22-Jun-2010 22-Jun-2010 28-Jun-2017 30-Jun-2020 Female beneficiaries Percentage 0.00 52.00 52.00 Comments (achievements against targets): Achievement against revised target is 169.5% Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Number of people in rural Number 0.00 600,000.00 800,000.00 1,356,340.00 areas provided with access to Improved Water Sources 22-Jun-2010 22-Jun-2010 28-Jun-2017 30-Jun-2020 Page 31 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) under the project Comments (achievements against targets): Achievement against revised target is 169.5% Objective/Outcome: Reliability of water supply services under the project area Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Reliability of water supply Hours 0.00 16.00 16.00 services under the project area 22-Jun-2010 22-Jun-2010 30-Jun-2020 Comments (achievements against targets): Achievement against target is 100% Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Percentage of installed water Percentage 0.00 100.00 100.00 supply system functional 22-Jun-2010 22-Jun-2010 28-Feb-2020 Comments (achievements against targets): Page 32 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Objective/Outcome: Number of people with access to improved sanitation under the project Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion People provided with access Number 0.00 600,000.00 672,676.00 to "improved sanitation facilities” under the proj. 22-Jun-2010 22-Jun-2010 30-Jun-2020 People provided with access Number 0.00 600,000.00 672,676.00 to ?improved sanitation facilities?- rural 22-Jun-2010 22-Jun-2010 30-Jun-2020 Comments (achievements against targets): Achievement against target is 112% Objective/Outcome: Number of communities in project area declared free of open defecation Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Communities in project area Number 0.00 550.00 1,052.00 declared free of open defecation (number) 22-Jun-2010 22-Jun-2010 30-Jun-2020 Comments (achievements against targets): Achievement against target is 191% Page 33 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Objective/Outcome: Water systems with ratio of revenues over O&M costs (including depreciation) equal or greater than 1 Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Water systems in project Percentage 1.00 1.00 0.90 areas with ratio of revenues over O&M costs (including 22-Jun-2010 22-Jun-2010 28-Feb-2020 depreciation) >=1.0(percent) Comments (achievements against targets): Insufficiently available information. Objective/Outcome: Direct project beneficiaries of which (percentage) are females Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion percentage of female Percentage 0.00 52.00 52.00 beneficiaries 22-Jun-2010 22-Jun-2010 28-Feb-2020 Comments (achievements against targets): Page 34 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) A.2 Intermediate Results Indicators Component: Rural and Small Town Water Supply Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Orphan boreholes Number 0.00 300.00 376.00 rehabilitated 22-Jun-2010 22-Jun-2010 30-Jun-2020 Comments (achievements against targets): Achievement against target is 125% Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Former GWCL systems Number 0.00 15.00 15.00 transferred to communities rehabilitated 22-Jun-2010 22-Jun-2010 30-Jun-2020 Comments (achievements against targets): Achievement against target is 100% Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Page 35 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) New community water Number 0.00 9.00 9.00 systems fed from GWCL 22-Jun-2010 22-Jun-2010 30-Jun-2020 Comments (achievements against targets): Achievement against target is 100% Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion New water systems based on Number 0.00 1,200.00 1,373.00 boreholes fitted with hand pumps operational 22-Jun-2010 22-Jun-2010 30-Jun-2020 Comments (achievements against targets): Achievement against target is 114% Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion New mechanized boreholes Number 0.00 40.00 60.00 58.00 operational 22-Jun-2010 22-Jun-2010 28-Jun-2017 30-Jun-2020 Comments (achievements against targets): Page 36 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion New water systems for small Number 0.00 30.00 60.00 75.00 towns operational (number) 22-Jun-2010 22-Jun-2010 28-Jun-2017 30-Jun-2020 Comments (achievements against targets): Achievement against target is 125% Component: Rural and Small Town Integrated Sanitation & Hygiene Promotion Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Improved latrines Number 0.00 40,000.00 56,228.00 constructed under the project 22-Jun-2010 22-Jun-2010 30-Jun-2020 Comments (achievements against targets): Achievement against target is 140% Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Page 37 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Communities sensitized Number 0.00 600.00 1,168.00 about hygiene practices and eradication of open free 22-Jun-2010 22-Jun-2010 30-Jun-2020 defecation Comments (achievements against targets): Achievement against target is 194% Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion New Institutional toilet Number 0.00 200.00 400.00 568.00 facilities constructed and operational 22-Jun-2010 22-Jun-2010 28-Jun-2017 30-Jun-2020 Comments (achievements against targets): Achievement against revised target is 142% Component: Institutional Strengthening and Project Management Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Key institutions (CWSA, Number 0.00 4.00 4.00 MOFEP, MSWR, MMDAs) trained in the use Sector 22-Jun-2010 22-Jun-2010 30-Jun-2020 Page 38 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Information Systems Comments (achievements against targets): Achievement against target is 100% Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion District Assemblies operating Number 0.00 94.00 94.00 DiMES 22-Jun-2010 22-Jun-2010 30-Jun-2020 Comments (achievements against targets): Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Timely submittal of clean Percentage 0.00 1.00 0.85 (unqualified) FM audit reports (percent for each 22-Jun-2010 22-Jun-2010 28-Feb-2020 participating DA) Comments (achievements against targets): Indicator Name Unit of Measure Baseline Original Target Formally Revised Actual Achieved at Page 39 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Target Completion Acceptable implementation Percentage 0.00 1.00 0.88 (including safeguards) quarterly reports delivered 22-Jun-2010 22-Jun-2010 28-Feb-2020 on time (percent for each participating DA) Comments (achievements against targets): Formally Revised Actual Achieved at Indicator Name Unit of Measure Baseline Original Target Target Completion Subproject implementation Percentage 0.00 1.00 0.88 in accordance with timetable in procurement plan (percent 22-Jun-2010 22-Jun-2010 28-Feb-2020 for each participating DA) Comments (achievements against targets): Page 40 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) B. KEY OUTPUTS BY COMPONENT Objective/Outcome 1: Expand access to water supply services in rural and small town communities 1. People in project area with access to improved water supply Outcome Indicators 2. Direct project beneficiaries, of which are female 1. Number of new water systems based on boreholes fitted with hand pumps operational 2. Number of new piped systems for small towns operational 3. Number of improved community water points constructed or Intermediate Results Indicators rehabilitated under the project 4. Number of new community piped systems fed from GWCL 5. Number of orphan boreholes rehabilitated 6. Number of former GWCL piped systems transferred to communities rehabilitated 1. 1,356,340 direct project beneficiaries (people in rural areas provided with access to improved water sources under the project) 2. 1,373 new water systems based on boreholes fitted with hand pumps operational Key Outputs by Component 3. 58 new mechanized boreholes operational (linked to the achievement of the Objective/Outcome 1) 4. 75 new water systems for small towns operational 5. 9 new community piped systems fed from GWCL 6. 376 orphan boreholes rehabilitated 7. 15 former GWCL systems transferred to communities rehabilitated Objective/Outcome 2: Expand access to sanitation services in rural and small town communities 1. People in project area with access to improved sanitation Outcome Indicators 2. Communities in project area declared free of open defecation 1. Number of household toilet facilities with handwashing facilities Intermediate Results Indicators constructed Page 41 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) 2. Number of new institutional toilet facilities constructed and operational 3. Number of communities trained to improve hygiene behavior or sanitation practices under the project 1. 672,676 people provided with access to improved sanitation facilities Key Outputs by Component 2. 56,228 improved latrines constructed under the project (linked to the achievement of the Objective/Outcome 2) 3. 568 new institutional toilet facilities constructed and operational 4. 1168 communities sensitized about hygiene practices and eradication of open free defecation Objective/Outcome 3: Ensure water supply and sanitation services in rural and small town communities are sustainable 1. Water systems in project areas with ratio of revenues over O&M Outcome Indicators costs (including depreciation) >= 1.0 (%) 2. Reliability of water supply services in project area 1. Number of District Assemblies operating DiMES and trained in the operation of sector information system 2. Number of key institutions trained in the use of Sector Information System 3. Subproject implementation in accordance with timetable in Intermediate Results Indicators procurement plan (%) 4. Acceptable implementation (including safeguards) quarterly reports delivered on time (%) 5. Timely submission of clean (un-qualified) FM internal audit reports (%) 1. 94 District Assemblies operating DiMES and trained in the operation Key Outputs by Component of sector information system (linked to the achievement of the Objective/Outcome 3) 2. 4 key institutions (CWSA, MOFEP, MSWR, MMDAs) trained in the use of sector information system Page 42 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) ANNEX 2. BANK LENDING AND IMPLEMENTATION SUPPORT/SUPERVISION A. TASK TEAM MEMBERS Name Role Preparation Ventura Bengoechea Task Team Leader(s) Emmanuel Nkrumah Water and Sanitation Specialist Harold Esseku Team Member Ajith Kumar Water and Sanitation Specialist Anders Jensen M&E Specialist Robert DeGraft-Hansen Financial Management Specialist Baba Imoru Abdulai Procurement Specialist Beatrix Allah Mensah Social Development Specialist Supervision/ICR Yitbarek Tessema Mammo Task Team Leader(s) Charles John Aryee Ashong Procurement Specialist(s) Robert Wallace DeGraft-Hanson Financial Management Specialist Esinam Julia Nduom Financial Management Specialist Lydia Sam Procurement Team Mohammad Ilyas Butt Procurement Team Wendwosen Feleke Team Member Ayishetu Terewina Team Member Harold Esseku Team Member Elizabeth Naa Amoah Akushey Team Member Franklin Kuma Kwasi Gavu Environmental Specialist Gloria Malia Mahama Social Specialist Alexandru Cosmin Buteica ICR Main Contributor Adams Kwaw Social Specialist Page 43 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) B. STAFF TIME AND COST Staff Time and Cost Stage of Project Cycle No. of staff weeks US$ (including travel and consultant costs) Preparation FY10 37.126 116,212.39 Total 37.13 116,212.39 Supervision/ICR FY11 44.341 103,652.87 FY12 39.030 62,679.39 FY13 35.822 66,171.78 FY14 37.170 51,783.64 FY15 23.575 41,732.97 FY16 15.942 32,789.85 FY17 19.825 50,406.18 FY18 29.158 68,459.10 FY19 14.704 86,030.42 FY20 18.160 141,984.63 FY21 0 411.61 Total 277.73 706,102.44 Page 44 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) ANNEX 3. PROJECT COST BY COMPONENT Amount at Approval Actual at Project Percentage of Approval Components (US$M) Closing (US$M) (US$M) Rural and Small Town Water 47.60 85.22 179% Supply Rural and Small Town Integrated Sanitation & 18.60 21.04 113% Hygiene Promotion Institutional Strengthening 11.10 14.27 128% and Project Management Total 77.3 120.53 156% Page 45 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) ANNEX 4. EFFICIENCY ANALYSIS Background 1. The Sustainable Rural Water and Sanitation Project Development Objective (PDO) was: “to expand access to and ensure sustainable water supply and sanitation services in rural and small-town communities in six regions.” To this end the project financed (i) construction and rehabilitation of point sources and piped water supply systems (ii) provision of technical assistance to promote and create demand for sanitation facilities and partially support the implementation of those facilities; and (iii) capacity building and strengthening of the various institutions within the decentralized structure, as well as support for M&E and project management. 2. The major project beneficiaries were rural communities and small towns selected based on key factors including high poverty levels, low service coverage, number of communities practicing open defecation, incidence of water and sanitation-related diseases, and high number of cases of under-five mortality and morbidity due to diarrheal diseases. At appraisal the number of beneficiaries was estimated to be 600,000 and later increased to 800,000 at the additional financing. 3. Cost of the Project: The Project was financed through an IDA credit amounting to SDR 82.7 million (US$120.7 million equivalent) 13 of which US$76.27 million was allocated for water systems, US$28.89 million for sanitation, and US$15.54 million for Institutional Strengthening, Sector Information System and Project Management. The original project cost was estimated to be XDR 49.7 million (equivalent to US$ 75 million). However, an additional financing amounting to XDR 33 million (equivalent to US$ 47.5 million) was later approved to address cost overrun and include additional beneficiaries 14. While the sanitation target remained unchanged with the AF, the target for water supply was revised upwards to reflect the greater number of people and system to be covered by the additional investments. 4. Project Duration: The initial project closing date was June 30, 2016. The SRWSP project was first restructured on June 27, 2016 to extend the project closing date by 12 months from June 30, 2016 to June 30, 2017. A second restructuring for the SRWSP project occurred in June 2017, recording a 6-month extension of closing date from June 30, 2017 to December 31, 2017 to provide time for signing of the Credit Agreement for the Additional Financing. The Additional Financing (AF) for SRWSP Financing Agreement (US $45.7 million equivalent) was signed on November 29, 2017 with an original closing date of December 31, 2019. The AF SRWSP project was last restructured in December 2019 to extend the project closing date by 6 months, from December 31, 2019 to June 30, 2020. 5. Disbursement: At project completion the project had almost fully utilized and document US$ 120.53 million, which was 99.9% of the allocation. At project completion only US$ 1.55 million remained 13Each beneficiary district was initially supposed contribute five percent of capital investment cost of water subprojects. Small towns were selected by the DA based on criteria that include: poverty, existing water and sanitation facilities (number of people per facility), district-development plans, and expressed willingness of community members to assume full responsibilities for O&M, including replacement of assets at the end of their useful life, of the selected facilities. 14 The additional financing is used to finance the cost of new system in areas initially designed to be covered through rehabilitation of existing schemes, the inclusion of communities located at the water source not initially targeted, change of distribution mains from PVC pipes to HDPE pipes and change of Plastic Tanks in the smaller communities to concrete/steel tanks as well as inclusion of cost of connecting schemes to electricity from the national grid which was overlooked at appraisal. Page 46 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) undisbursed including US$ 1.38 million exchange rate gains 15 over the duration of the project. Table 4 (see below) shows financial allocation at appraisal, revisions and utilization at completion by components and subcomponents. Achievements of the project 6. The four years extension of project implementation (through the US$ 47.5 million additional financing) had implications on the return to investment due to increased cost and delayed project benefits. However, the project exceeded its revised end program targets both in terms of people provided with access to improved water supply (169% of the revised targets) and people provided with improved access to sanitation services (112%) as well as well as communities who attained ODF (191%) 16. In addition, comparing the actual expenditure spent under each component with the respective beneficiaries showed that the project was more cost effective compared to the assumptions at appraisal and at the restructuring. The actual per capita cost for provision of improved water supply at completion was US$ 62.83, which was lower than US$ 79.0 estimated for the original project and US$ 93.3 million revised at AF. See table 4 for detailed achievements. 7. The project was expected to increase water consumption from 10 liters per capita per day (lpcd) to 20 lpcd for consumption at stand pipe and 60 lpcd at household connection. As per the findings of beneficiary assessment survey conducted by Community Water and Sanitation Agency (consultant) per capita water consumption had improved as per the design in the six participating regions ranges from 135 lpcd at Ahafo, Bono and Bono East Regions, to 22 lpcd at Northern, North East and Savannah Regions 17. The survey also showed that 91% of households included in the survey responded that the project had increased their access to potable water and reduced their travel time to fetch water, which contributed to punctuality of children in school with water much nearer to their homes. 15 The project did not encounter significant loss or gain due to change in exchange rate between commitment currency (SDR) and disbursement currency (US$). There was approx. US$ 1.38 million exchange rate gain over the project period. As reported in the PCR depreciation of Ghanaian cede against US$ on the average about 26% had created delays in completion of contracts due to rise in the cost of services and goods in cedi 16 Overall 1,356,340 people (as against a revised target of 800,000) gained access to improved water supply. This was made up of 889,831 people gaining access to water supply in the Parent project against a revised target of 650,000 and 466,449 people gaining access to improved water supply from the Additional Financing against a target of 150,000. This is about 36% and 210% higher than the revised appraisal targets – thus 69% over the cumulative target. Overall 672,676 people gained access to improved latrines in beneficiary rural communities and small towns against a target of 600,000. This surpassed the target by 12% of the revised targets. About 1,052 communities achieved Open Defecation Free (ODF) status against a target of 550. In addition, 568 schools and clinics were provided with improved latrines 17 135 lpcd at Ahafo, Bono and Bono East Regions, 48 lpcd at Central Region, 22 lpcd at Northern, North East and Savannah Regions, 27 lpcd at Upper East Region, 33 lpcd at Upper West Region and 39 lpcd at Western & Western North Regions. Page 47 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Table 4: Major changes in project parameters since appraisal and results achieved Original Revised Result at No. KEY INDICATORS Unit Target (PAD) Target at AF Completion 1 Project Cost A. Rural & Small-Town Water Supply US$ 47,420,000 76,270,000 85,217,356 B. Rural & Small-Town Sanitation & HES US$ 16,630,000 28,890,000 21,038,258 C. Institutional strengthening & Project Management US$ 10,950,000 15,540,000 14,274,337 Total US$ 75,000,000 120,700,000 120,529,952 2 Outcome Indicators People provided with access to Improved Water number Sources 600,000 800,000 1,356,340 People provided with improved sanitation facilities number 600,000 600,000 672,676 Communities in project area declared free of open number 550 defecation 550 1,052 3 Intermediate Indicators New water systems for small towns operational number 60 75 30 New water systems based on BHs with hand pumps number 1,200 operational 1,200 1,373 Number of improved latrines constructed under the number project 40,000 40,000 56,228 New Institutional toilet facilities constructed and number 200 400 568 operational 4 Per Capita Cost Improved Water Supply US$ 79.0 95.3 62.8 Improved Sanitation US$ 27.7 48.2 31.3 Cost Benefit Analysis: 8. The main objective of the CBA at project completion is to examine the validity of the CBA conducted at appraisal and latter at the additional financing at project completion. 9. The ex-post CBA is estimated following the same methodology and basic assumptions used at appraisal and AF. The CBA will combine both original project and additional financing and no separate analysis was conducted. The CBA is mainly based on government draft PCR and household survey conducted by consultant. Due to the current constraint posed by COVID-19 no consultation was made with project stakeholders including beneficiaries and local governments to support and validate some of the assumptions used in the analysis. Page 48 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) 10. Scope: At appraisal and additional financing, the financial return of the project was measured by its NPV and IRR estimated at 12% discount rate and 15 years of economic life for the water supply schemes. The scope of the CBA conducted at appraisal was limited to only financial returns of the water supply interventions excluding sanitation interventions and indirect cost and benefits of the project. 11. Benefit Stream: The financial inflows consist mainly of revenue from the sale of (incremental) water production and connection fees for new customers and consumer surplus estimated at 130 % of the revenue from incremental sales of water. The benefit from sales of incremental water supplied by the project is estimated using a tariff rate of GHS 5.5/ m3 based on the findings of the beneficiary assessment report. 12. Cost stream: Investment cost, operational cost and asset replacement cost are included in the cost stream: (i) for investment costs the actual expenditure reported under component 1 including borehole drilling, civil works, rehabilitation of schemes, transmission line for connection and design and supervision cost are considered. In addition, 80% of institutional strengthening and program management costs are included as program management costs; (ii) operational costs including sinking fund 18 for replacement of assets is estimated at 5 pesewas per bucket (18 liter). 13. Accordingly, the CBA at project completion revealed the project intervention is still financially viable 19 as demonstrated by positive NPV amounting to US$ 7.54 million and IRR of 17.3%, which is greater than the discount rate. While the return to investment at completion is lower than the estimates at the original project it is higher than the estimates at the additional financing. (see details at Table 5). Table 5: Comparison of Economic NPV and Internal Rate of Return for Sanitation Intervention No Description of At Appraisal At Additional At Project intervention Financing Completion NPV in ‘000 IRR NPV in IRR NPV in IRR US$ ‘000 US$ US$ 1 Financial Analysis 26,488.61 20.5% 11% 7,538.16 17.26% 14. The positive NPV and the IRR greater than the discount rate estimated at completion show that despite extension of project duration for about four years and cost overrun which resulted in an additional financing of US$ 47.5 million, the project interventions are found to be financially viable. This finding may signal that the impact of cost overrun and delayed benefit resulting from prolonged implementation is somehow compensated by over achievements of the PDO and intermediate result indicators. 15. While the project is financially viable when considered in aggregate, it conceals the financial status of each town as there is inbuilt cross subsidy in the analysis. The analysis will not show whether each 18 Communities are responsible for their sustainable operation and maintenance, and will need to establish funds needed for the replacement of the capital items the SF is estimated assuming replacement of assets after 20 years and 2 percent real rate of interest (this time saving rate), the annual charge for a sinking fund is 4.12 percent of the cost of construction. Or 2 to 3 pesewas per bucket (18 litter) 19 While the project is financially viable when considered in aggregate, it conceals the financial status of each town as there is inbuilt cross subsidy in the analysis. The analysis will not show whether each small town will recover cost of operations and maintenance from the current tariff. As per the beneficiary survey it is reported that some towns particularly smaller ones are unable to cover their O&M cost from the current tariff (GHS 5-6/m3). Page 49 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) small town will recover cost of operations and maintenance from the current tariff. As per the beneficiary survey it is reported that some towns particularly smaller ones are unable to cover their O&M cost from the current tariff (GHS 5-6/m3). 16. There are several potential benefits that are not factored into the cost-benefit analysis both at completion and at appraisal. These include improved health due to reduction of water borne diseases 20, additional income from productive use of time saved in fetching water, improvement in the environment due to a reduction in open defecation and increased enrollment and reduction in school dropout rate. In addition, the project could contribute to the global reduction of GHG emission whose potential benefit is not included in the analysis. Therefore, the estimated benefits from the project can be considered conservative, and it can reasonably be assumed that the actual benefits will be much higher than this. 17. Sanitation Improvement: Out of US$ 28.9 million allocated for sanitation US$ 21 million is spent at project completion. 672,676 people have benefited from the sanitation intervention through promotion of good hygiene and sanitation practices, support for the construction of latrines in private homes, and the construction of institutional latrines in selected schools and clinics, as well as activities aimed at behavioral change to bring about Open Defecation Free (ODF) status in the communities. Though this component is not included in the CBA analysis the per capita cost estimated at completion showed that it is cost effective compared to the revised resource allocation and targets. The actual per capita cost for provision of improved sanitation services at completion was US$ 31.3 which is higher than US$ 27.7 estimated for the original project and lower than US$ 48.3 million revised at AF. See Table 4 for detailed achievements. 20According to Guy Hutton’s Water and Sanitation Assessment on Benefits and Costs of the Water and Sanitation Targets for the Post 2015 development agenda (January 2015), access to improved community water source, basic piped water and piped water high quality have an impact of reducing diarrheal disease by 34%, 45% and 79% respectively. Page 50 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) ANNEX 5. BORROWER, CO-FINANCIER AND OTHER PARTNER/STAKEHOLDER COMMENTS SUSTAINABLE RURAL WATER & SANITATION PROJECT (4789-GH 6128-GH) WATER AND SANITATION AGENCY COMMENTS ON IMPLEMENTATION COMPLETION AND RESULTS REPORT – March 2021 The Community Water and Sanitation Agency have studied the Project’s Implementation Completion and Results Report and is in general agreement with the findings sand ratings as outlined in the report. The Project Development Objectives which are to expand access and ensure sustainable water supply and sanitation services in rural and small-town communities in originally six regions (eleven regions currently as a result of organization of the region) of Ghana are achieved as stated. Below are comments on the components: Component A – The new pipe water systems completed is 75 in total and rehabilitation and expansion is 15. The Regional breakdown is as follows: Item Region New Pipe System Rehabilitation and expansion Total 1 Upper West 7 3 10 2 Upper East 13 0 13 3 Northern, North East and 3 12 15 Savannah 4 Bono, Bono East and Ahafo 10 0 10 5 Central 26 0 26 6 Western, Western North 16 0 16 7 Total 75 15 90 NB: 11 of the new water systems in the central region are connection to transmission lines from GWCL systems (11 clusters) that covers communities and small towns totaling 147. Component B – The total number of institutional toilets completed is 431 Pupils toilets and 568 Teachers toilets. Component C – No comment. Best Regards, Submitted by: Ing. Konadu Owusu (Project Coordinator) Page 51 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) ANNEX 6. SUPPORTING DOCUMENTS (IF ANY) • Project Appraisal Document (PAD) – dated May 28, 2010 • Financing Agreement – dated September 8, 2010 • Project Paper for the AF – dated June 7, 2017 • Financing Agreement AF – dated November 29, 2017 • Project Information Document (Appraisal Stage) • Project Restructuring Papers • Implementation Status Reports (numbers 1 - 19) • Bank Preparation and Supervision Aide Memoires and Management Letters • Country Partnership Strategy for FY13 – FY16 – dated August 20, 2013 • Systematic Country Diagnostic – dated November 14, 2018 • Bank Guidance: Implementation Completion and Results Report (ICR) for Investment Project Financing (IPF) Operations – dated March 3, 2020 • Borrower’s Completion Report – dated June 2020 • Beneficiary Assessment Report – dated June 2020 Page 52 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) MAP OF THE PROJECT Page 53 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) SAMPLE PHOTOS OF THE PROJECT Photo 1: Solar powered water pumping systems (Nalerigu, North East Region), with remote control and flow data management system (operational efficiency with reduced cost of energy and climate resilient system) Photo 2: Demonstration of the smart water supply system with prepaid token for demand management (Bontrease, Central Region) Page 54 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Photo 3: Water management office in East Mamprusi Photo 4: Elevated reservoir to ensure adequate reserve and head pressure in Prang Page 55 of 56 The World Bank GH:Sustainable Rural Water & Sanit Serv (P120026) Photo 5: Rehabilitation of existing water treatment plant at Yapei Photo 6 (left side): Completed latrine with hand washing facility Photo 7 (right side): Digni-loo slab under installation Page 56 of 56